Treating Shoulder Impingement
Pinching of the complex structures in the shoulder is a common cause of pain.
Pain in the shoulder can have several possible causes. If shoulder pain increases as you raise your arm, and the pain is worse when it's straight out at 90 degrees, your problem may be impingement.
The shoulder is a complex structure. A ball at the top of the upper arm bone (humerus) fits into a socket in the shoulder blade (scapula). A group of muscles and tendons (rotator cuff) surrounds the joint.
Fluid-filled sacs, called bursae, function as cushions to reduce friction. These structures all work together to allow for great range of motion. But sometimes these tissues can get irritated.
"As you raise your arm up, the tendons or bursa can get pinched between the humerus and the collar bone (clavicle) on top of the scapula," says Cleveland Clinic physical therapist Kelly Kinsey PT. If this happens continuously over time, you can develop impingement syndrome. If it goes on for too long, the tendons can start to fray and potentially tear.
What You Can Do
"With stretches, we can improve the mechanics of the shoulder so you're no longer pinching the tissues," says Kinsey. The problem is many people try to strengthen the shoulder before stretching.
"Some people come to see us after they've done a bunch of strenghening exercises, and they've just irritated it," says Kinsey.
She advises beginning by improving your posture. Sitting in a slouched position causes the shoulder blades to come forward, which can cause pinching. To counter this, sit up straight and tall and squeeze your shoulder blades back and together. This opens up the space under the clavicle to make room for the rotator cuff.
When you sleep on your side, don't support your head by putting your arm under your pillow. Use a taller pillow instead.
The next step is stretching exercises to improve range of motion. A physical therapist can teach you mild-to-moderate stretches, such as the ones below. These stretch out the muscles to create more space.
While the shoulder heals, avoid repetitive overhead activities. With these measures, most people improve within three to four weeks. If you are no better or symptoms are worse, get a further evaluation.
Range of Motion Exercises
Standing or lying down, use both hands to raise a cane overhead. Hold for 15 seconds and repeat five to 10 times.
Rest your arm on the wall. Relax your neck and arm. Gently turn your body away from the arm until a stretch is felt in the front of the chest or shoulder. Hold for 15 seconds and repeat five to 10 times.