One of the most common injuries that we see in our clinic is what is known as shoulder impingement.
You may have heard of it described as bursitis, cuff impingement or rotator cuff impingement. The various names are because there are a number of different structures in the shoulder that can contribute. However, the symptoms are generally the same – people describe a sharp pinching pain in the outside shoulder and upper arm region, often when they are doing overhead activities, side lying, reaching behind your back or lifting with that arm. This can happen suddenly after a fall or forced sudden movement, or can come on over time. Some of the causes we see are people falling on to the outside part of their shoulder, or even more commonly, doing a lot of overhead weights at the gym or in their everyday life – particularly if they are not used to doing these movements or do a lot of them all of a sudden.
If you doing overhead activities, either at the gym or just with normal day-to-day activities, there are some things you can do to decrease your risk of developing impingement problems.
Be aware of where your scapula (shoulder blade) muscles are positioned: when we try to lift something that is too heavy for us, we often end up trying to compensate by rounding or hunching our shoulders up towards our ears. This decreases the normal space in your shoulder where the important tendons of the shoulder sit, which increases the likelihood of pinching those tendons between the bones of the shoulder and inflaming them. Instead, think about trying to tuck each of your shoulder blades back and down to the middle of the back to improve the stability of the shoulder – and lower the weight or ask for help.
When you are at the gym, don’t overload the shoulder muscles, particularly what are known as the rotator cuff muscles. This is an important muscle group that helps the arm move away from the side and rotate, and also stabilises the shoulder in its socket. The cuff muscles aren’t big or powerful, as their job is one of endurance and stability, so don’t do routines that work the shoulders two days in a row – let the muscles recover. This can include chest and back strengthening exercises, as they can also fatigue the shoulder muscles. Fatigued muscles can mean abnormal movement patterns, which can lead to impingement and injury.
Be careful when lifting heavy items in overhead positions, as your shoulder is less stable in this position and the muscles have to work hard to hold the arm here and keep the shoulder stable. Have a break from doing overhead activities regularly, as the muscles can tire quickly.
Don’t ignore pinching pains in your shoulder: these are warning signs that something is being irritated, and can progress if ignored. Recognise the difference in your body between fatigue and distress pains. Get those niggles assessed by an appropriate health professional who can guide you as to what to do next.
Often, simple changes in posture and work/exercise habits plus some simple exercises can be enough to sort out the problem you are having with shoulder impingement, so get early advice, follow that advice, and hopefully you will be back on track in no time.
Can I take this opportunity to wish all of the Hibiscus Matters readers a happy and safe holiday season.
This is Andy’s final column for Hibiscus Matters and we thank him for all his contributions over the past few years.