You are suffering pain, weakness and stiffness in a shoulder and are then told by your Physiotherapist to perform special, regular shoulder movements. Moving a painful body part many times a day may not seem logical but let's take a look why this can be a good approach.
This is a painful condition when the rotator cuff muscles become irritated and inflamed and can also be referred to as 'swimmer's shoulder' or 'thrower's shoulder'. The rotator cuff muscle can reach this state if it's normal passage becomes obstructed or narrowed by developing bony structures, arthritic spurs or thickening of a nearby ligament. The rotator cuff muscle and tendon have very little room to swell if injured and therefore any swelling will only increase the pinching sensation and pain on the muscle and /or tendon.
In some muscle injuries simple rest will lead to eventual healing of the affected area. However, due to the unique anatomical constraints of the area surrounding the rotator cuff, pain is much more likely to lead to ongoing muscle damage if left untreated.
The first step is to reduce inflammation and this can be achieved with medication and or electrotherapy treatment. Ice packs can also help as well as reduce localised pain. In addition, manual therapy as well as needling/ acupuncture techniques are clinically very effective in alleviating pain and helping to restore movement, thereby allowing for exercises which will help maintain movement and improve strength and control.
If the muscle damage is severe or the presence of impinging structures have been identified, it can be necessary for surgical intervention.
It's important to recognise the type of movements that should be avoided with shoulder pain. You don't want to be putting direct strain on the painful muscle and this usually means not raising your elbow above shoulder level or carrying any heavy weight with the affected arm. Prolonged use of the shoulder in repetitive activities should also be avoided, so best to avoid washing the car for instance.
It's very important to get assessed and have daily exercises recommended that are suitable for your individual condition. It is therefore not a good idea to describe general exercises here. Specific exercises prescribed by a Physiotherapist, with detailed explanation for proper technique, will aim to maintain range of movement and avoid stiffness in the painful shoulder. This can reduce and prevent further development of pain and injury and is an important element of treating pain from shoulder impingement syndrome.
by Lorraine Carroll.