One of the most common types of shoulder pain that comes into the clinic is called secondary shoulder impingement. Here is a brief description of what it is and what we you can do about it. It’s a short read that may be worth your time.
Basically, shoulder impingement is the feeling of pinching in the shoulder joint with overhead activities. It can be accompanied with aching pain that lasts throughout the night (bursitis), pain down the arm and weakness. Here’s some more associated issues related to shoulder impingement.
Microtrauma (repetitive eccentric, or negative overload) to rotator cuff muscles produces great amounts of tendon stress. This overload promotes the inherent avascularity of the supraspinatus and the infraspinatus muscles near their insertion as well as the biceps tendon that courses over the head of the humerus. Adduction causes wringing out of the tendon and its surrounding vessels. Decreased blood flow means decreased healing potential. We need to address this. So stop sleeping on your shoulders, sleep on your back to start in your recovery.
Muscular weakness and imbalance is widely seen in the population in part due to the imbalance between strong internal rotators and weak external rotators and is seen during anterior shoulder flexion. This can cause an impingement of the humeral head on the anterior labrum and may force the humeral head to rise anteriorly and superiorly against the acromion during flexion. The rotator cuff secures the shoulder joint. Rotator cuff problems can start from neck and spine dysfunctions. Do you have a tight neck too? Not uncommon. I also recommend you read more about various Chiropractor treatments and consider having this assessed by a professional.
Tightness in the pectoralis minor and short head of the biceps, which insert on the coracoid process of the shoulder blade can result in scapular winging, abnormal scapular tilt leading to more impingement. An unopposed deltoid can create a superior migration of the humerus too. It is not only important to examine the strength of the rotator cuff muscles but we also have to look at the shoulder blade, scapular muscular strength to protect against recurrent deltoid shear and instability due to weakness of the dynamic shoulder stabilizers. Keep your shoulders back and your chest out, this is a big part of rehab, start now.
Many components of this dysfunctional complex can be treated and re-trained with appropriate exercises and manual therapy. If you have shoulder pain consider getting assessed to determine the biomechanics of your shoulder and the required course of treatment to return to optimal function.
Written By: Dr. Jeff Almon
Dr. Jeff Almon is a certified Doctor of Chiropractic in BC and has been a certified strength and conditioning specialist (CSCS) since 2003. He can be located at the Lifemark Chinatown Physiotherapy Clinic Downtown Vancouver
