Shoulder Impingement Syndrome (SIS)
Shoulder impingement syndrome (SIS) refers to the trapping of the rotator cuff muscle tendons that pass through the shoulder joint in a narrow bony space called the sub-acromial space. Impingement means to impact or encroach on bone, and repeated pinching and irritation can lead to injury and pain.
This type of injury can vary from mild tendon inflammation (tendonitis), bursitis (inflamed bursa), calcific tendonitis (bone forming within the tendon) through to partial and full thickness tendon tears (full tears may require surgery).
Over time, the tendons can thicken due to repeated irritation, progressing the problem as the thicker tendons battle to glide through the narrow bony subacromial space.
What causes Shoulder Impingement?
Generally, SIS is caused by repeated, overhead movement of your arm into the “impingement zone”, causing the rotator cuff to contact the outer tip of the shoulder blade (acromion).
You may have heard of Swimmer’s Shoulder or Thrower’s Shoulder, since the injury occurs from repetitive overhead activities.
Shoulder impingement has primary (structural) and secondary (posture & movement related) causes.
Primary Cause:
- Structural narrowing in the space, e.g. from osteoarthritis, bony spurs
Secondary Cause:
- Instability of the shoulder
- Combination of excessive joint movement, ligament laxity and muscle weakness
- Muscle imbalance from overuse, e.g. swimming, throwing sports
What are the symptoms?
Symptoms commonly include:
- An arc of shoulder pain approximately when your arm is at shoulder height and/or overhead
- Shoulder pain extending from top of the shoulder down the arm to the elbow
- Pain lying on the sore shoulder, night pain and disturbed sleep
- Muscle weakness or pain when attempting to reach or lift
- Pain when putting your hand behind your back or head
Pain reaching for the seat-belt, or hanging up clothes
How can Physiotherapy help?
Our physiotherapists at Pain Free Physiotherapy & Allied Health are experienced at using a holistic approach to assess the body as a whole to look for all contributing factors to your shoulder pain.
Early stages of treatment may include:
- Hands-on manual therapy
- Strapping/taping techniques
- Specific rehabilitation exercises
Some shoulder impingement cases may be more stubborn and frustrating, taking between 3-6 months to resolve. However, shoulder impingements will usually respond positively and quickly to physiotherapy treatment.
If you are suffering from shoulder pain or impingement, visit your physiotherapist to get your shoulder checked and become pain free!
