by Cathy Richey and Mark Lamendola
Shoulder impingement, more properly called "impingement syndrome," happens when the bones and tissues in your upper arm or shoulder are not aligned correctly. The misalignment narrows the space around which the muscles of your shoulder move.
This is often accompanied by inflammation and swelling, which exacerbate the main symptom: pain when you move your shoulder. And sometimes, pain even when you don't.
Left untreated, shoulder impingement can lead to serious problems that even surgery can't fix.
Fortunately, treatment can solve the problem if applied early enough. Even more fortunately, you can reduce the likelihood of the condition if you know what to do. Toward that end, you need to know the risk factors and causes.
Impingement is common in young athletes, due to overuse, overtraining, impact, poor nutritional habits, and other contributors. Young athletes who use their arms overhead for swimming, baseball, and tennis are particularly vulnerable.
Those who do repetitive lifting or overhead activities using the arm, such as paper hanging, construction, or painting are also susceptible.
It's also common in older adults, though for mostly other reasons. Improper exercise by middle-aged men trying to pretend they are young, lack of exercise, poor posture, and poor nutrition are some of the behaviors that lead to this problem.
Regardless of age, pain may develop as the result of minor trauma. It may occur suddenly and viciously, with no apparent cause. But, there is a cause.
These are some causes of shoulder impingement (definitions are below):
How do you know if you have shoulder impingement? Self-diagnosis has a low accuracy rate, so facilitating that isn't our intention here. Our intention here is to help you see the signs that you have a problem that requires you to change what you are doing. And change right away. Here are some symptoms:
Impingement commonly causes local swelling and tenderness in the front of the shoulder, but not always. The problem may result in tender tissue that hurts to the touch, but not always. You may feel pain when you lift that arm, and/or you may feel pain when you lower it.
The cost of doing nothing
When confronted with pain, most people will take some aspirin or some other pain reliever and continue with business as always. That's not how you handle shoulder impingement. Your shoulder is alerting you to a problem that can quickly get worse. Much worse.
As the problem progresses, there may be pain at night. Strength and motion may be lost. It may be difficult to do activities that place the arm behind the back, such as buttoning or zippering.
In advanced cases, loss of motion may progress to a "frozen shoulder." All movement may be limited and painful.
At this point, most folks will head to the doctor. Though it's not too late to prevent permanent damage, your activity level will have to be severely curtailed. Had you taken action at the onset, you would likely have had full recovery in one to three weeks. Now, you are looking at several months. Bone spurs may have developed, and surgery is very likely even if they haven't.
At this point, popping pain relievers and hoping the problem will go away is a ticket to permanent damage including painful arthritis.
So, what can you do at the onset to head off this bleak scenario? Let's take a look....
Perform these steps in this order:
Most people think rest means "don't use it." Read those last two bullet points (above) again. And, here's more on that topic.
The current thinking can be summed up as "use it or lose
it." In the past, for example, you might have been told to keep your arm in
a sling for weeks. Physical therapists make it their top priority to "get
you going" again as soon as possible. Why? Because keeping the shoulder
immobilized causes the muscles to weaken and atrophy; furthermore,
immobilization weakens bones and joint cartilage, and promotes soft-tissue
You should be exercising your shoulders on a regular basis, allowing a minimum of 96 hours between shoulder workouts for the muscles to properly recover. The shoulder consists of three muscle groups. It is critical you work the rear deltoids. Failure to do this will result in an unstable shoulder. Even if you never exercise the other two groups directly, work those rear delts.
Go into any gym, and nearly everyone working shoulders is doing a counterproductive workout. Here are some tips:
In sports-related activities, learn proper technique to prevent painful and expensive shoulder problems. [Source: www.drkoop.com]
A couple of the words used earlier are a real mouthful. Here's what they mean:
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