shoulder pain + impingement

Shoulders are incredibly complex in nature and rely on near perfect timing of the muscles in the area to keep them healthy. So it’s no wonder that with so many variables so many people experience shoulder pain at some point in their life.

Today we’re going to chat at a very over-viewed level about the most common shoulder injury we see here at TCSS; shoulder impingement syndrome.

Shoulder impingement is kind of a ‘catch all’ term that gets thrown around a lot but what’s happening in a true external shoulder impingement are tendons, ligaments or bursa (fluid filled sacks preventing friction) get pinched, or impingement, under the bony structures of the shoulder girdle.

shoulder pain impingement
Shoulder impingement mechanism

The shoulder is made up of three bones; the humerus (arm bone), the scapula (shoulder blade) and the clavicle (collar bone). The muscles of the shoulder joints are collectively called the rotator cuff. This is a combination of four muscles (supraspinatus, infraspinatus, teres minor + subscapularis) and is responsible for holding the humerus “down and in” within the shoulder joint.

In the scheme of things, the rotator cuff muscles are actually pretty small but they need to fire just riiiight for things to move correctly. So when these muscle decide to get lazy either from overuse or some sort of injury, the head of the humerus no longer has anything holding it down and larger muscles in the area will try to ‘help’ and take over. This allows the head of the humerus to jam up into the shoulder joint and pinch everything that happens to get in its way. Ouch.

Your body will try to avoid this pain pattern so you may start to subconsciously avoid the painful motion but what almost always happens is that pain will start to move its way along the kinetic chain; this is when that neck or midback pain start to show up along with your shoulder pain.

So what can you do? Being evaluated is step one. Since there are so many variables that play into shoulder pain it is important to get a proper diagnosis. Then, certain manual therapies and rehab programs can be put into place. At TCSS we utilize several manual therapy techniques for the soft tissue component of the injury and also look to adjust or mobilize any joints that are feeling restricted. A patient specific rehab program is then initiated to help the rotator cuff fire correctly and also balance musculature in the area.

As with any injury, it’s important to take care of them before they’ve progressed into a tendinopathy or potentially a torn muscle. If you’re experiencing shoulder pain or have any questions, get in touch with us today!

Dr. Katie Clare, DC, CCSP, ART

Dauntless Sport & Spine Clinic
4510 W. 77th St, Edina, MN 55435

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