Shoulder dysfunction and pain are frequently encountered because of incorrect mechanics and lack of muscular stabilitysupport. Corrective exercises for shoulder impingement shoulder pain may be a common ailment affecting between 4 to 20 percent of the population at any given point. R rest consider using a shoulder sling for the first 12 days if your shoulder is painful. Your doctor may send you to a physical therapist for exercises or other therapy. These have been recommended by the uks leading shoulder physiotherapists and proven to reduce pain and improve your shoulder. Shoulder impingement syndrome is a condition that causes severe discomforts and can interfere with various daily activities.
Shoulder injuries are rampant among exercisers and this indepth course will show you specific exercises and techniques for common, chronic shoulder conditions. Injury causing pain may debilitate the patient and cause frustration in the recovering. Step towards things rather than stretch for them to make movement easier for your shoulder. Shoulder impingement rehabilitation protocol exercise. Nonsurgical shoulder impingement rehabilitation protocol ramin r. Another basic exercise that helps loosen you up is the shoulder roll. Pilates and shoulder impingement pilates equipment. Elevatethearmsusingthehealthyarmtoguidethe injuredarm. This exercise isnt suitable if you have a shoulder impingement. Shoulder impingement exercises that work michael curtis pt. A good functioning shoulder requires that one has sufficient stability and control while doing activities.
Exercises for shoulder impingement if you are involved in a sport which involves overhead shoulder activity like tennis, badminton, swimming or sports which involve regularly throwing a ball, then the chances are that you are at risk of shoulder impingement. Increasing soft tissue flexibility and joint mobility is one of the important aims of the shoulder impingement syndrome. Subacromial impingement syndrome sis is a painful, and often long lasting, shoulder condition affecting patient function and quality of life. Keeping these muscles strong can relieve shoulder pain and prevent further injury. I ice you should rest from all activities that cause shoulder pain.
Understand the evidence with regard to establishing a prognosis for patients with shoulder instability including pathoanatomic features as well as the. Door lean stand in a doorway with both arms on the wall slightly above your head. Shoulder impingement syndrome handout the portland clinic. Sports injury medicine department 9250 sw hall blvd.
Slowly lean forward until you feel a stretch in the front of your shoulders. Movement system impairment syndromes of the shoulder. Sitting or standing shoulder impingement page 6 shoulder impingement keep your arms relaxed. The rotator cuff is a group of four muscles that surround the shoulder and are. Rotator cuff and shoulder conditioning program orthoinfo aaos. The other phases of rehabilitation will not be effective until pain is controlled. Often accompanies impingement no change in shoulder pain with neck rom exam tender to palpation overlying proximal biceps tendon at bicepital groove pain with extension of the shoulder pain with resisted supination of wrist and resisted biceps flexion pain with speeds resisted shoulder flexion with wrist supinated and. Apply a bag of crushed ice or frozen peas to the shoulder for 20 minutes after performing the exercises to prevent in. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Pull your shoulder blades downward and hold for 5 seconds. You may try some over the counter antiinflammatory medication like ibuprofen or your physician may prescribe you one. Shoulderbursitis often occurs in sports withoverheadactivities suchas swimming,tennis, orthrowing.
Pdf the strengthening exercises in shoulder impingement. Know about various back and shoulder blade exercises for this problem, along with appropriate pictures to guide you. Strengthening the muscles that support your shoulder will help keep your shoulder joint stable. Objective to investigate the effectiveness of conservative interventions for pain, function and range of motion in adults with shoulder impingement. It mayalso occurin occupationalactivities suchas paintingorcarpentry. Codmans exercises, aarom, arom with cane, pulley to advance to active rom in front of. The patients treated with specific exercises responded with reduced pain and improved shoulder. You should feel this exercise at the back of your shoulder and into your upper back. Nonsurgical shoulder impingement rehabilitation protocol.
Movement system impairment syndromes of the shoulder shirley sahrmann, pt, phd, fapta professor emeritus program in physical therapy program in physical therapy mosby 2001 elsevier 2010 program in physical therapy the human movement system the body system for which physical therapists are responsible. General exercise can really help your recovery so try to keep going with other activities you enjoy to keep fit. If you dont exercise regularly try and build something in even a brisk 20 minute walk 3 times a week will help. Exercise programmes for patients shoulder pain caused by. Pendulum exercises bend forward at the waist, back parallel to ground is ideal.
Normal st motions that occur during arm elevation in any plane include upward rotation, posterior tilting, and either internal or external rotation. Start with arm midway between the front and side of your body, thumb down. Stretching the muscles that you strengthen is important for restoring range of motion and preventing injury. Effectiveness of conservative interventions including. It provides stability and strength for the shoulder joint, anchoring the humerus upper arm bone to the scapula shoulder blade so that movements of the arm can occur in a. Shoulder impingement is a condition characterized by pinching or compression of soft tissue, such as the rotator cuff tendons and the subacromial bursa, between the upper arm bone humerus and roof of the shoulder acromion during certain movements of the shoulder, such as arm elevation. The exercises overleaf may stop the tendons and bursa being pinched and the pain may resolve. In 2 previous publications we have demonstrated that a specific exercise program was more effective than an unspecific control exercise program in reducing the need for surgery in subacromial pain patients at 3 and 12month followups holmgren et al. This booklet will show you how to do them within the comfort of your home. How mobilizing and strengthening can help your shoulder impingement the aim of treatment for your shoulder impingement is to address your positional impairments 12 the stiffness in your spine and the weakness in your shoulder blade muscles, 14. Following you will find a list of detailed exercises that research has shown will help with shoulder. The shoulder impingement zone is located between the head of your humerus shoulder s ballshaped bone and the top of your shoulder blade known as the acromion. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision.
Home exercise program for shoulder impingement perform the exercises in the order listed. Theraband exercises internal rotation, external rotation, extension, beginning with yellow bands 3foot length. Osteoarthritis of the shoulder often presents with posterior shoulder pain that can extend to the muscles of the upper tips for evaluating and treating shoulder problems in older adults if pain occurs during abduction at 60120o of arc, a rotator cuff problem either tendinitis impingement or a tear is the likely diagnoses. Dynamic stretching are stretches that are pain free and held for 15 seconds and repeated 1015 reps. Infraspinatusteres minor 1 seated er 17 high 2x30 pain free range of motion 2 side lying er 17 moderate 2x3050.
Shoulder impingement is a very common cause of shoulder pain, where a tendon band of tissue inside your shoulder rubs or catches on nearby tissue and bone as you lift your arm. The rotator cuff is made up of four muscles supraspinatus, infraspinatus, subscapularis, and teres minor and their tendons. Pdf stretching exercises for shoulder impingement syndrome. Understanding shoulder dysfunction course description.
Shoulder impingement page 2 gentle exercises theseexercises can help you to move better and lessen your shoulder pain. It affects the rotator cuff tendon, which is the rubbery tissue that connects the muscles around your shoulder. If you are unable to do any form of exercise because of pain, the. Sports and orthopaedic specialists sports and orthopaedic specialists pendulum exercises codmans 1. Poor mechanics of your shoulder blade is a common finding in people with shoulder impingement 11. Webinar information sheet webinar title exercise etc. Neutral position of the back, shoulders, and spine should be maintained during standing, sitting, and lifting activities. Let your arm move in a circle, first clockwise, then. Although the exercises may be hard work, tight or uncomfortable, they should not be painful. Pain in your shoulder is often a symptom of shoulder. Because the shoulder joint is not a stable joint, it is extremely important to develop correct mechanics and balanced muscular support, especially when dealing with a shoulder impingement. Download the pdf below for exercises that can help to ease shoulder pain and prevent future symptoms. Swelling inside the shoulder may worsen the pain and contribute to further injury. Explain the shoulder pain classification and methods used to categorize patients into shoulder cpg categories, specifically shoulder instability 2.
Elder care college of nursing and health innovation. Another thing you can try is using ice for 2030 minutes several times daily to. During normal shoulder function, there should not be an impact of the scapulas bony acromion. Rotator cuff sprain and strains university of california.
The subacromial bursa sits over the top of the cuff, allowing for the cuff tendons to slide near the roof of the shoulder without undue friction. Exercise programmes for patients shoulder pain caused by subacromial impingement this leaflet describes two exercises which are designed to strengthen your shoulder cuff. Impingement syndrome rotator cuff tendinitis, bursitis. Impingement syndrome is characterized by pain in the shoulder due to inflammation of the rotator cuff. Shoulder impingement is a common condition presumed to contribute to rotator cuff disease.
Taking them before exercise can help you stay active without causing extra pain. Impingement can occur externally with the coracoacromial arch or internally with the glenoid rim. Study selection criteria randomised controlled trials including participants. Kavanagh, pac this protocol provides general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. The rotator cuff is a series of four muscles that surround the ball of the shoulder humeral head. Surgery may be required to treat shoulder tendinitis and bursitis if it becomes chronic or if there is a tear of the rotator cuff. Effects of 6week program on shoulder tightness, pain and disability status by turgut e, duzgun i, baltaci g journal of sport. Stretching exercises for shoulder impingement syndrome. After an injury or surgery, an exercise conditioning program will. Allow involved arm to hang down, perpendicular to the floor. Pdf the strengthening exercises in shoulder impingement trial. Your shoulder should start to feel better within 6 to 12 weeks if you do the simple exercises on the following pages.
If one shoulder is lower, square it by lifting that one, up and back. Once able to perform 3 sets of 10 repetitions without pain or fatigue, progress to the red band, and then to the green band. Using an ice pack, learning how to protect your joints and being aware of your posture will help cases of shoulder pain. Youll explore exercise modalities for clients who are living with impingement, rotator cuff tendinitis. Data sources medline, central, cinahl, embase and pedro were searched from inception to january 2017. Shoulder impingement exercises definition, treatment and. Exercises to strengthen the shoulder may help to prevent a recurrence. Shoulder impingement my doctor online kaiser permanente. Each one is easy to perform so you wont have to jump through any hoops to aster the steps. In a recent study, we observed major strength impairments in shoulder external rotation and abduction 30% in a population of patients with pronounced and longlasting sis. After 72 hours, ice the shoulder after activity or exercise. Participate in cardiovascular exercise such as walking. Rotator cuff and shoulder rehabilitation exercises.