Have you ever felt shoulder pain when reaching up for something in the cupboard? Or perhaps when putting on a shirt? Or maybe when doing pressing movements in the gym?
What is shoulder impingement?
It is very possible you may be suffering from something called shoulder impingement.
Shoulder impingement occurs when the tendon of one of your rotator cuff muscles rubs or is squished under a hook shaped prominence on your scapula called the Acromion. When this friction or compression occurs, the tendon becomes inflamed and thickens, leading to more friction and compression and you can see where I’m going here. To make matters worse, there is also a fluid filled sack called a bursa in that same tiny space that can become inflamed as well.
What causes shoulder impingement?
The main causes of shoulder impingement are over-use and poor posture/biomechanics. Athletes at risk of this injury are swimmers, baseball players and tennis players (due to the high involvement of the shoulder joint in these sports)
Common activities that can cause shoulder impingement are painting, lifting boxes overhead and cleaning anything above eye level.
After listing some of these activities, you are probably thinking that shoulder impingement might seem inevitable. We use our shoulders and reach for things overhead so much in our daily lives.
What factors can increase or decrease our risk for this injury.
Now we’ve explained how the tendon of the rotator cuff can become impinged under the Acromion. If we can increase the space under the acromion so that those tendons do not rub, we can decrease our chance of shoulder impingement.
When we lift our arms over our heads, both the scapula and the humerus are moving at different times and at different ratios. This is called Scapulo-humeral rhythym. Now I won’t go into those exact numbers too much but essentially for proper scapulo-humeral rhythym, the scapula needs to be stabilized effectively as well as rotated posteriorly (backwards) and the humerus needs to be unrestricted (moving smoothly) when going overhead.
What muscles are affected with shoulder impingement?
If you’re suffering from shoulder impingement these are the muscles that likely need work and stretching or strengthening these muscles may assist you in your recovery.
Muscles that stabilize the scapula when lifting the arms over head:
(We want to strengthen these)
- Serratus Anterior
- Lower & Middle Trapezius
Muscles that restrict the humerus travelling overhead:
(We want to stretch these)
- Pec Major
- Latissimus dorsi
Muscles that restrict the scapula rotating posteriorly:
(We want to release this one)
- Pec minor
What to do if you are suffering from shoulder impingement?
stop any movements that cause pain. As we learned before, this injury is a positive feedback loop that can easily lead to a vicious cycle of inflammation and pain. Anything that can help decrease inflammation at this point is a good start. Ice, compression, cutting out inflammatory foods like refined sugars, dairy or gluten or incorporating anti-inflammatory foods into your diet like ginger, fish oils and turmeric.
Release those above-mentioned muscles (Lats, Pecs) by stretching, foam rolling getting in there with a lacrosse ball or by seeing one of our registered massage therapists.
We want to build a solid foundation in our scapulo-thoracic joint by strengthening our middle and lower traps as well as the boxers muscle the serratus anterior. If you think you may benefit from building strength in these muscles, book in with a physiotherapist or active rehab specialist to learn how to properly activate and strengthen these muscles.
When you do become pain free, continue with your strengthening and mobilization routines to prevent further injuries in the future. Not only can you prevent injuries but by creating a strong shoulder and scapulo-thoracic joint, you can improve performance in sport and in the gym.