Updated: Mar 3
What is shoulder impingement syndrome?
Shoulder impingement syndrome is a common condition that occurs when the tendons and/or bursa of the shoulder joint become compressed or inflamed as they pass through the narrow space known as the subacromial space. This can cause pain and discomfort in the shoulder and make it difficult to perform certain activities such as raising your arm or reach above your head. Shoulder impingement syndrome can occur at any age, but is more common in aging population. As we age, tendons and other soft tissues become less elastic and less able to handle stress and strain. Additionally, years of wear and tear can lead to the development of osteophytes or other structural changes in the shoulder joint that can contribute to impingement.
In aging adults shoulder impingement syndrome is more likely to occur as a result of chronic overuse or repetitive strain in occupation involving overhead activities and sports such as tennis and baseball. It may also be associated with other conditions that become more common with age, such as Arthritis. However, it is important to note that not all cases of shoulder pain in older adults are due to impingement syndrome. Other conditions, such as rotator cuff tears and frozen shoulder, can also cause shoulder pain and stiffness.
How does physical therapy help with Shoulder impingement syndrome?
Physical therapy is often an effective treatment option for shoulder impingement syndrome. A physical therapist can design a personalized exercise program to strengthen the muscles around the shoulder joint, improve range of motion, and reduce pain and inflammation.
Physical therapy goals for shoulder impingement syndrome include:
1.Pain and inflammation reduction: This can be achieved using ice, heat, ultrasound, or electrical stimulation.
2.Improved range of motion: Stretching exercises and joint mobilization techniques can help increase the range of motion of the shoulder joint.
3.Shoulder Strengthening: Exercises that strengthen the rotator cuff muscles and other muscles around the shoulder joint can help support and stabilize the joint.
4.Correct Posture and Alignment: Poor posture and alignment can contribute to shoulder impingement syndrome. A physical therapist can provide exercises and guidance to improve your posture and alignment.
5.Functional training: This involves practicing an individual's daily activities or sport-specific activities to improve the overall function of the shoulder joint.
Consistently and diligently following a physical therapy program is critical to see improvement. The duration of treatment depends on the severity of the condition, but it may take weeks or months for optimal results. Surgery may be necessary if conservative treatment is unsuccessful.
A randomized controlled trial published in the Journal of Shoulder and Elbow Surgery in 2021 found that a combination of manual therapy and exercise was more effective than exercise alone in improving pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis published in the Journal of Orthopedic & Sports Physical Therapy in 2020 found that exercise therapy was effective in reducing pain and improving function in patients with shoulder impingement syndrome, and also that a significant difference between exercise types found no significant difference in the results. A randomized controlled trial published in BMC Musculoskeletal Disorders in 2018 found that a home exercise program was as effective as clinic based physical therapy in improving shoulder function and reducing pain in patients with shoulder impingement syndrome.
Overall, these studies suggest that exercise therapy is an effective intervention for shoulder impingement syndrome, and that a combination of manual therapy and exercise may be more effective than exercise alone. It is important to consult your doctor to determine the best treatment plan for your individual needs.
Physical therapy for Shoulder impingement syndrome
1.Rotator Cuff Strengthening Exercises: Includes exercises such as external rotation with resistance bands or dumbbells, internal rotation with resistance bands or dumbbells, and cutting with resistance bands or light weights.
2.Scapular Stabilization Exercises: These may include exercises such as scapular retraction and descent, scapular protrusion and elevation, and scapular push-ups.
3.Posterior Capsular Stretches: May include exercises such as cross-body stretches and sleeper stretches.
4. Thoracic mobility exercises: Thoracic mobility exercises may include exercises such as thoracic extension with foam rollers and thoracic rotation with foam rollers.
5.Dynamic Stabilization Exercises: These include exercises such as wall walks in which you gradually climb up a wall while maintaining good control of your shoulder blades.
Before starting an exercise program for shoulder impingement syndrome, it is important to consult with a physical therapist or medical professional to ensure that the exercise is safe and suitable for your individual needs. It also helps in designing an exercise program.
Exercises for Shoulder Impingement syndrome in aging adults
Although the exercises recommended for shoulder impingement syndrome are generally suitable for older adults, some modifications and additional considerations may be necessary. The following are specific to older adults with shoulder impingement syndrome. Examples of research-based exercises.
1.External Rotation with Elastic Resistance: This exercise targets the rotator cuff muscles and can be performed with elastic bands or a theraband. Sit with the elbow bent to her 90 degrees and the forearm resting on a table or bench. Then rotate your shoulders outward and bring your elbows closer to your body. A study published in the Journal of Strength and Conditioning Research in 2014 found that this exercise was effective in improving external rotation strength in older adults with shoulder pain (Diederichs et al., 2014).
2.Wall Angel: This exercise targets the muscles around the shoulder blades and can be done while standing against a wall. Stand with back against the wall, arms bent at 90 degrees, elbows at shoulder level. Then, slide your arms up the wall as far as you can, keeping your elbows and forearms in contact with the wall. A study published in the Journal of Shoulder and Elbow Surgery in 2019 found that this exercise improved scapular kinematics and muscle activity in older adults with shoulder impingement syndrome (Soranun et al., 2019).
3.Elastic Standing Row: This exercise targets the upper back muscles and can be done with a rubber band or tube. The patient stands with their feet shoulder-width apart and their arms extended to hold a band or tube in front of their body. Then pull the band/tube toward your chest while squeezing your shoulder blades together. A study published in the Journal of Aging and Physical Activity in 2015 found that this exercise improved upper body strength and functional performance in older adults with shoulder pain (Diederichs et al., 2015).
4.Wall slide: This exercise targets the muscles in your upper back and can help improve your posture. The patient stands with their back against the wall and slides the arm up and down the wall, keeping the elbow and forearm in contact with the wall. It is important to note that older people have less resistance and may progress more slowly than younger people. It is important to consider health conditions and restrictions. A health care provider or physical therapist can provide guidance on appropriate exercises and modifications. A study published in the Journal of Sports Science and Medicine in 2013 found that this exercise improved scapular muscle activity and shoulder range of motion in older adults with shoulder impingement syndrome (O'Sullivan et al., 2013).