Grove Life Winter 2020

Shoulder Impingement Dr. Benjamin Galin, DPT, OCS

SUNSET YOGA

L et me add a preface of standard disclosure here. Obviously, everyone has unique medical conditions and concurrent co-morbidities that make any general rule of thumb comments needed to be taken with some grain of salt. Please know that you should consult with your medical team about how to treat your specific conditions, and that this medical information contained here within is merely general advice and a starting point for learning and an educated discussion with your physicians and therapists to help determine what is best for you in treating shoulder dysfunction and pain. Though not readily seen on MRI or X-Ray, shoulder impingement is one of the most common non-traumatic sources of shoulder pain in adult populations. Even in this picture, the biceps tendons, and most of the rotator cuff is not shown, and you can see just how crowded the space is under the Acromium process (Label A). Shoulder impingement is not something that is the same for everyone, but it is something

that happens while lifting the arm away from the body. It can be both a root cause of tendonitis, bursitis, and tears, and can also be the result of the aforementioned conditions. When you lift your arm, the coordination of the shoulder blade muscles and the rotator cuff muscles and the arm muscles is intricate. Even on an athlete, this precise motion leaves little room under the Acromium process for the bursa and rotator cuff tendons to function without getting pinched. Throw in rounded shoulder posture, weak muscles in any of these groups, tight shoulder capsule shoving the

rotation axis up even further under this space (sub-acromial space); and you have a recipe for disaster. Over time the friction of the motion under the sub-acromial space will cause rotator cuff tendons to be stripped and torn, the bursa to become very inflamed, and this will make the pinching even worse and cause a cycle of impingement that snowballs. Impingement can lead to frozen shoulders from fear avoidance patterns, to rotator cuff tears, severe bursitis, and generally make it very painful to use your arm away from your body. The key is having a good examination to find out if there is indeed impingement, what is causing it, and formulating a plan of correction. Fixing usually requires capsular mobilization, scapular stabilizer strengthening and timing, rotator cuff strengthening, and pain and anti-inflammatory modalities as needed. If you think you have shoulder impingement, see your orthopedist or physical therapist to get your shoulder functioning optimally and get out of pain. Get back on the court, on the fairway, or just back to lifting your arm over your head without pain with proper diagnosis and treatment. If you want a consult with “Dr. Ben” stop by and schedule with him at the Fitness Center today. Dr. Ben is a Doctor of Physical Therapy with Board Specialty in Orthopedics On-Site Physical Therapy at Boca Grove

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