Comprehensive Approach to Shoulder Impingement Relief

The following is an excerpt from Dr. Gorecki’s and Dr. Fuson's brand new book – “The Truth Unveiled: Secrets to Shoulder Pain Relief”.

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Beyond Band-Aids: A Comprehensive Approach to Shoulder Impingement Relief

Shoulder impingement is a common issue that affects many people, especially athletes who engage in overhead activities like throwing, serving in tennis, and certain swimming strokes. It can also affect anyone who needs to reach overhead in their daily activities.

Shoulder impingement happens when the rotator cuff tendons in the shoulder joint get pinched. There are two types of impingement: internal and external. While this distinction is important from an anatomical perspective, it's less important when it comes to figuring out what's causing the impingement and how to fix it.

In the world of physical therapy, we use the principles of Applied Functional Science (AFS) to understand and treat shoulder impingement. AFS looks at how the whole body works together in three dimensions and how different parts of the body affect each other in a chain reaction.

One key principle in AFS is "LOAD & EXPLODE." This means that before we can do any movement (EXPLODE), we need to prepare our body for it (LOAD). In cases of shoulder impingement, the problem often arises during the EXPLODE phase, like when reaching overhead. However, the pain is usually caused by not loading the body properly.

Let's take an example of pain when lifting the arm to the side (abduction). This pain is often caused by the acromion (a bony part of the shoulder blade) not moving out of the way as the arm lifts. If the shoulder blade doesn't move properly during the LOAD phase, the EXPLODE phase will be less than optimal. To find the cause of the impingement, we need to trace the chain reaction all the way to the ground. For example, when lifting the right arm to the side, the LOAD phase includes moving the shoulder blade towards the spine, bending the upper body to the right, moving the left hip towards the body, and rolling the left foot inward. If there's a problem anywhere along this path, it can cause impingement.

On the other hand, if the client has pain at the end of lifting the arm overhead, we need to look at the EXPLODE phase. The lack of rotation of the shoulder blade, extension of the upper spine, and extension of the hip can all be potential causes. The shoulder blade won't move out of the way without rotating, and it will be restricted by the rib cage if the upper spine doesn't extend enough. Tight hip flexors limiting hip extension will also affect the upper spine extension.

At Superior Physical Therapy, we use the 3D Movement Analysis and Performance System (3DMAPS) to assess all the joints in each of the three planes of motion. This helps us identify where the root dysfunction lies. If you want to heal from shoulder impingement without medication, injections, or surgery, consider coming to us. We won't just treat the painful area with a band-aid; we'll find the root cause of the problem.

The Risks of Untreated Shoulder Impingement

It's important to understand that leaving shoulder impingement untreated can have serious consequences. One of the most significant risks is the development of a rotator cuff tear. The rotator cuff is a group of four muscles and their associated tendons that stabilize the shoulder joint. When the rotator cuff tendons are repeatedly pinched or impinged, they can become inflamed and weakened over time.

As the impingement continues, the tendons may start to fray and become more susceptible to tearing. This can happen gradually due to ongoing wear and tear, or suddenly as a result of a specific movement or injury. A rotator cuff tear can cause pain, weakness, and limited range of motion in the shoulder, making everyday activities like reaching overhead, lifting objects, or even getting dressed more difficult.

Treating shoulder impingement early is crucial to prevent further damage to the rotator cuff tendons. By addressing the root causes of impingement and improving the way the shoulder and surrounding areas function, we can reduce the risk of a rotator cuff tear and help you maintain strong, healthy shoulders.

At Superior Physical Therapy, we take a comprehensive approach to shoulder impingement, focusing on the whole body and the chain reactions that contribute to the problem. By identifying and addressing the root dysfunction, we can help you heal naturally and avoid the long-term consequences of untreated impingement.