Shoulder Impingement syndrome in the shoulder is a very common condition that can affect patients across a huge age range. Shoulder impingement can also be referred to as subacromial impingement, supraspinatus syndrome, swimmer’s shoulder, painful arc syndrome and thrower’s shoulder.
It can occur when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space, the passage beneath the acromion (the space between the ceiling of the shoulder and the top of the ball of the shoulder joint). This commonly results in pain, weakness and loss of movement.
The pain can come on suddenly or it can be a gradual onset. Pain can manifest itself in the front of the shoulder or top of the shoulder, but as this is such a complex area, patients also describe pain down the upper arm, into the elbow, back of the wrist and the back of the shoulder.
Physiotherapy is the first line of treatment for this condition. This generally involves soft tissue release work to improve the position of the shoulder and to encourage healing of the rotator cuff muscles, as well as other modalities such as Shock Wave Therapy, postural correction, stretches and strengthening programmes tailored to the individual.
The evidence for this approach is clear and building. The British Journal of Sports Medicine in 2017 stated that ‘for pain, exercise was superior to non-exercise control interventions. Specific exercises were superior to generic exercises. Manual therapy was superior to placebo. When combined with exercise, manual therapy was superior to exercise alone, but only at the shortest follow-up. Extracorporeal shockwave therapy (ECSWT) was superior to sham and tape was superior to sham.’
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