Saturday, 13 August 2011

Injury Management: Shoulder Impingement (Subacromial)

I have decided to start posting some information about the most common injuries experienced by bodybuilders at the gym. Hopefully there is enough detail in these posts to help you to identify, treat and self manage your own injuries! However... whenever in doubt, consult your local general practitioner/physiotherapist.


Anatomy:
Shoulder joint

** In normal shoulder movement, the bursa and rotator cuff tendons glide smoothly under the acromion. Shoulder impingement occurs when these structures are compressed during shoulder movement. If left unattended, this may lead to a tear of the bursa and/or rotator cuff muscle.



Overview:
  • compression of the structures (namely the bursa and rotator cuff tendons) under the acromion
  • pain is usually elicited when raising the arm above the head
  • exercises such as shoulder press, lat pull down, lateral/front raise and overhead throwing may predispose the shoulder to impingement

Causes:
  • hooked/curved acromion
  • acromial spurs
  • inflammation of tendons/bursa (aka tendonitis, bursitis) from overuse
  • poor scapulohumeral rhythm

Signs and Symptoms:
  • pain at the front/side shoulder area
  • pain reproduced with shoulder movement, especially overhead
  • painful arc may be present
  • difficulty sleeping on affected side

Treatment:
  1. Rest from any aggravating activities
  2. Anti-inflammatory medication (if indicated)
  3. Stretch all neck/shoulder muscles
  4. Graduated exercise program: Range of motion movements (passive/active), Weighted pendulum, Shoulder theraband exercises (Internal/External rotation, Adduction, Extension), Scapula stabilising exercises, Postural correction, Biomechanical correction, Gradual return to activities)
  5. If all the above fails: cortisone injection, surgery
If you would like to know more information about shoulder impingement, feel free to drop me a comment below. The information provided is a very rough guideline of the management of this particular injury.

8 comments:

  1. any rough ideas on why my right knee hurts during heavy squats ? seems ok on everything else on leg routine.

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  2. Where abouts is the pain in your knee exactly?

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  3. well just had it again today its basicly just under the knee cap in the middle

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  4. You probably have a bit of Patella tendonitis. A good way to reduce the pain is by off loading the tendon. This can be achieved using patella tendon taping where a force is applied across the patella tendon.

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  5. hey man thanks for the tip, i looked into it on the net, bought some tape from local chemist and its feeling okay this week after heavy squats, now to overcome my new back pain! haha

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  6. Glad to know it helped! Remember to incorporate some eccentric work to help with the control of your quads without exacerbating your patella tendon.

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  7. I think I injured my shoulder around 1.5 years around when I started working out. I can feel the pain in posterior and anterior part of my shoulder (deltoid). I tried goin to acupuncture and physio therapy, it helped but not completely. I also tried youtubing exercises. the trainer said it was related to my rotator culf?? is there anything i could do to completely heal it? thanks!

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  8. @gordo512 You need to STOP all exercises/shoulder positions that cause ANY pain at all. Your body will heal providing that you give it time to heal. Since it has been 1.5 years, it's likely that you have developed a lot of scar tissue in the particular injured structures in your shoulder.

    Keep up with the Rotator cuff exercises (pain free). Persistence will pay off in the end. I have had a shoulder problem that took almost a year to completely heal. Don't give up! And train smart.

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