Shoulder impingement is a common yet often debilitating condition that can affect anyone, from athletes to those with sedentary lifestyles. Physiotherapy and diagnostic imaging can together play a crucial role in managing shoulder impingement and assessing the severity of the compression and inflammation.

Physiotherapists can offer personalised treatment programs that alleviate pain, restore function, and prevent recurrence. By addressing the underlying causes and symptoms, individuals can regain shoulder mobility, strengthen muscles, and improve overall shoulder health.  

What is shoulder impingement? 

Shoulder impingement occurs when the rotator cuff tendons and the subacromial bursa (a protective sac within the shoulder) become compressed during arm movements. This compression can lead to inflammation, pain, and a limited range of motion, making daily activities challenging. 

Do I have shoulder impingement? 

Common symptoms of shoulder impingement include pain when lifting the arm, particularly when reaching overhead, as well as shoulder weakness, reduced range of motion, and discomfort that may worsen at night. The affected shoulder may feel tender, and simple tasks like reaching for objects or getting dressed can become challenging. 

How can I prevent shoulder impingement? 

Preventing shoulder impingement involves maintaining good posture, particularly avoiding rounded shoulders, and strengthening the muscles around the shoulder to support joint stability. Regular stretching and mobility exercises can help keep the shoulder flexible, while being mindful of repetitive shoulder movements or heavy lifting can reduce the risk of developing this condition. Early intervention is key to managing symptoms and preventing further complications. 

The benefits of physiotherapy in treating shoulder impingement 

Physiotherapy is a cornerstone in the treatment of shoulder impingement, offering a range of benefits that not only address the immediate symptoms but also promote long-term shoulder health. Here’s how physiotherapy can help: 

1. Pain relief 

One of the primary goals of physiotherapy is to alleviate pain. Techniques such as manual therapy, soft tissue mobilisation, and specific exercises are employed to reduce inflammation and relieve discomfort. The use of hands-on techniques can improve joint mobility and decrease muscle tension, providing immediate pain relief. 

2. Restoration of shoulder mobility 

Shoulder impingement often leads to a restricted range of motion, making it difficult to perform everyday tasks like reaching overhead or lifting objects. Through targeted stretching and mobility exercises, physiotherapists work to restore normal movement patterns in the shoulder. This helps patients regain full use of their shoulder, enhancing their ability to perform daily activities without pain. 

3. Strengthening the shoulder muscles 

Weakness in the rotator cuff and surrounding muscles can contribute to shoulder impingement. Physiotherapy programs include strength training exercises that target these muscles, helping to stabilise the shoulder joint and prevent future injuries. Strengthening the muscles around the shoulder also reduces the risk of further impingement and enhances overall shoulder function. 

4. Postural correction 

Poor posture, particularly rounded shoulders, is a common contributing factor to shoulder impingement. Physiotherapists assess each patient’s posture and provide exercises to correct any imbalances. Improving posture can alleviate the pressure on the shoulder tendons and reduce the likelihood of impingement reoccurring. 

5. Education and prevention 

We believe in empowering our patients with the knowledge they need to manage their condition and prevent recurrence. Physiotherapists educate patients on proper body mechanics, posture, and ergonomics to minimise stress on the shoulder during daily activities. This proactive approach helps patients maintain the benefits of physiotherapy long after treatment has ended. 

The role of imaging in diagnosing shoulder impingement 

While physiotherapy is highly effective in treating shoulder impingement, accurate diagnosis can come to be crucial to developing an effective treatment plan. This is where diagnostic imaging comes into play. 

Confirm the diagnosis: Imaging helps verify that shoulder impingement is indeed the cause of your symptoms, ruling out other potential issues like rotator cuff tears or osteoarthritis. 

Assess the severity: By visualising the extent of tendon compression and inflammation, the treatment approach can be tailored to the specific needs of each patient. 

Monitor progress: Follow-up imaging can be valuable in tracking the effectiveness of treatment and making any necessary adjustments to the treatment plan. 

Addressing shoulder impingement effectively requires a combination of targeted treatment, strength-building exercises, and proactive prevention strategies. By recognising the symptoms early and making lifestyle adjustments, such as improving posture and maintaining shoulder flexibility, you can significantly reduce the risk of developing or worsening this condition. As explained above, diagnostic imaging also plays a critical role in confirming the diagnosis and guiding appropriate treatment, ensuring that any underlying issues are accurately addressed. Taking these steps can help restore shoulder function, alleviate pain, and enable a return to normal activities without discomfort. 

Article from Excellence Physiotherapy – physiotherapy & osteopathy practice specialising in Adults (MSK, Sports, Neuro), Women’s Health and Paediatrics.