WELLNESS 360

SHOULDER PAIN

BY BETH PARRY

Treating Shoulder Pain

Shoulder pain is a common complaint amongst many older adults. Multiple reasons may cause your shoulder pain and discomfort. There is trauma or injury, including rotator cuff tear or full rupture. There are overuse injuries, including bursitis and tendonitis. The most common cause of shoulder pain is “impingement syndrome.” Some common symptoms of shoulder impingement include neck pain, shoulder pain, limited range of motion, numbness in the upper extremity, and weakness of the arm. Movements that stimulate pain are reaching behind your back, lifting your arms overhead, or lowering your arm from a lifted position. The pain is typically felt in the front of the shoulder and radiates into the side of the arm. These symptoms do not typically occur instantly; they progressively worsen over time and with overuse. In this article, we will discuss what shoulder impingement is and how you can treat shoulder pain.

What is Shoulder Impingement?

Shoulder impingement is defined as “inflammation of the shoulder joint from repetitive activities.” This is often exacerbated by overhead reaching or increased lifting/activity and is usually a result of abnormal muscle activation. This abnormal muscle activation can occur when the muscles become unbalanced due to postural deficits. In our world of forwarding posture at the computers, cell phone use, and dayto-day activities, we create imbalances in our musculature. Impingement, and the pain associated with it, happens when the postural muscles in our mid back between our shoulder blades (middle trapezius, lower trapezius, and rhomboids) are not working correctly to stabilize our scapular border. Our

rotator cuff muscles (teres minor and infraspinatus) are not working correctly to depress the head of the humerus in the joint. Additionally, when we have weak postural and core muscles, we tend to round our shoulders forward and slouch. This shortens our chest muscles, also known as our pectoralis muscles, causing them to become tight, further compressing the joint and impinging the muscles, tendons, and nerves that run through the Acromion joint. The combination of over-stretched muscles in the mid back and overly tight muscles in the front of the chest will decrease the space that the tendons, nerve routes, and muscles have to run through the top of the shoulder joint, known as the AC joint. Then those muscles, tendons, and nerve routes get pinched or impinged between the head of our humerus and the AC Joint. The decreased space in the joint causes rubbing and fraying of the tendons and muscles, causing inflammation.

Strengthening the rotator cuff and the muscles in our mid back and stretching the pectoral muscles can restore proper posture and motion in the shoulder joint, decreasing pain and inflammation.

So, what can be done to address this?

There are many things you can do to treat shoulder impingement. Physical Therapy is the most critical step you can make to decrease your shoulder impingement pain. A Physical Therapist will provide a full assessment of your movement patterns. We can first run you through evaluatory steps to pinpoint what is causing your shoulder pain. We can identify which muscles are tight and weak and prescribe specific exercises to correct the imbalances.

Other options to decrease your shoulder pain are rest and ice. When your shoulder is inflamed, using an icepack

“Shoulder pain is a common complaint amongst many older adults. Multiple reasons may cause your shoulder pain and discomfort.”

will help decrease the inflammation and decrease the pain. While rest and ice will alleviate symptoms, it is a temporary fix. A medical doctor can prescribe medications to help with decreased pain and inflammation. This, again, is just a temporary fix. It does not address the reason behind the inflammation. A combination between rest, ice, medications, and appropriate exercise through physical therapy is the best treatment for an impinged shoulder. This way, you treat the symptoms and the cause.

With exercise, strengthening weak muscles and stretching tight muscles allows the shoulder joint to move appropriately, decreasing compression and pain. Below are some simple exercises that can help with this: · Scapular squeezes. Pull your shoulder blades back and down. You should feel the muscles between those shoulder blades working and a slight stretch in the front of your chest.

Doorway pectoral stretch: Stand in a doorway with your forearm against the door jam. Then, lean forwards through the doorway, so your arm is stretched behind you. You should feel a stretch in the front of your chest.

Lay flat on your back: This will be our favorite (maybe). This can be extremely helpful in opening up the chest and letting the spine extend and stretch.

Wellness 360 provides one-to-one specialized treatment for shoulder impingement and so much more. Our team of specialized Physical Therapists and Medical Massage therapists works together to provide a comprehensive treatment based on your symptoms and imbalances. For more information or to make an appointment to have your shoulder evaluated, give Wellness 360 a call! (585) 259-0782