Impingement Sydrome v. Frozen Shoulder

Impingement Syndrome and Frozen Shoulder are very similar because they effect the shoulder joint but there are some differences.  Lets look at both and see what we can do about them.

Impingement Syndrome (I.S.):

We become more at risk for shoulder can happen as we get older because we become tighter and less mobile.  This condition can sometimes become a problem after bouts of shoulder bursitis or rotator cuff tendonitis.  Injuries to the shoulder inflame the tissues and can cause long term damage.  The rotator cuff muscles become tight and do not function properly leading to decreased movement of the shoulder.

What are the Symptoms?

Difficulty lifting a straight arm over your head or behind your back.  There can be tightness, pain and tenderness on the shoulder area. If this problem is not taken care of, chronic muscle tightness and atrophy can pull or rupture the bicep muscle or tendon limiting ability to bend the arm and elbow as well.

What can be done?

1. Stretching exercises

2. Proper alignment of the shoulder in the joint space

3. Muscle and tissue loosening with massage or sastm (a Graston Technique)

4. Ultrasound, Tens machines can also be used to stimulate the area

Frozen Shoulder (Adhesive Capsulitis)

What is a frozen shoulder?

Frozen Shoulder is similar to Impingement syndrome but the capsule of the arm is affected with loss of movement in all directions (over the head, to the side, backwards).  It happens during active motion (patient does it) or when the doctor moves it and the patient is relaxing the arm.

What causes a frozen shoulder?

Repetitive movements or injury to the shoulder which causes inflammation, scarring, thickening, and shrinkage of the shoulder’s  joint capsule which surrounds the shoulder joint and keeps muscles and tissues in place.

If you are diabetic, have chronic Rheumatoid Arthritis or have recently had chest or breast surgery you are at a higher risk of getting Frozen Shoulder.  Also, long term non-movement of the arm in its normal range of motion can develop frozen shoulder.

How do we know you have frozen shoulder?

During examination we will move your arm and see where its limitations are.  Orthopedic tests will be administered to test strength and neurological testing will be performed.

If necessary, an x-ray with contrast dye injected (Arthography) into the shoulder joint can show problems with the capsule.   Also an MRI can be taken to see soft tissue damage.

In order to help with this problem, proper stretching of the arm and rehabilitation is required.  Stretches must be done everyday to keep good blood flow, movement and mobility.  Here is the bad news….once you have frozen shoulder or impingement sydrome, you have to keep stretching.  It can and will come back.

Both of these problems need a lot of time for rehabilitation.  It can sometimes take be 6-8 months to get back to full function.  Be patient, it will happen, just a lot of hard work to get you back in the swing of things again.

Hope this makes sense to you.   If not, email me or blog back and I will clarify!

Rotator Cuff Injuries can creep up on you

Your rotator cuff consists of muscles and tendons on the upper part of your shoulder.  These muscles are responsible for rotating your arm outward (Teres Minor and Infraspinatus), rotating it inward (Subscapularis) and moving it away from your body (Supraspinatus).  Since we use our arms a lot, irritation or damage to the rotator cuff is fairly common.

Injuries to the area can result from falling on the shoulder, lifting and repetitive arm movements.  The most common cause of a rotator cuff injury occurs when you lift our arm over your head to throw a baseball or to open shelves that are above the shoulders.  Athletes and chefs commonly have problems with the shoulder.

Here are some common symptoms of a rotator cuff injury:

Pain and tenderness in your shoulder, especially when reaching overhead, reaching behind your back, lifting, pulling or sleeping on your side
Weakness
Limited movement in the shoulder
avoidance of lifting your arm over your head for fear of pain.

What causes a rotator cuff problem?

Normal wear and tear. Increasingly after age 40, normal wear and tear on your rotator cuff can cause a breakdown of fibrous protein (collagen) in the cuff’s tendons and muscles. This makes them more prone to degeneration and injury. With age, you may also develop calcium deposits within the cuff or arthritic bone spurs that can pinch or irritate your rotator cuff.
Poor posture. When you slouch your neck and shoulders forward, the space where the rotator cuff muscles reside can become smaller. This can allow a muscle or tendon to become pinched under your shoulder bones (including your collarbone), especially during overhead activities, such as throwing.
Falling. Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.
Lifting or pulling. Lifting an object that’s too heavy or doing so improperly — especially overhead — can strain or tear your tendons or muscles. Likewise, pulling something, such as a high-poundage archery bow, may cause an injury.
Repetitive stress. Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing. This occurs often in athletes, especially baseball pitchers, swimmers and tennis players. It’s also common among people in the building trades, such as painters and carpenters.
Being an athlete. Athletes who regularly use repetitive motions, such as baseball pitchers, archers and tennis players, have a greater risk of having a rotator cuff injury.
Working in the construction trades. Carpenters and painters, who also use repetitive motions, have an increased risk of injury.
Having weak shoulder muscles. This risk factor can be decreased or eliminated with shoulder-strengthening exercises, especially for the less commonly strengthened muscles on the back of the shoulder and around the shoulder blades.

Problems in your shoulder can be a long term problem.  When tissues are damaged it can take 8-12 weeks to heal.  Even after reconditioning the area you must keep up with it especially if you have a job that calls for repetitive shoulder movement.  I have had great success with S.A.S.T.M. to recondition the tissue along with proper alignment of the shoulder.  Incorporating exercises to strengthen the area really helps!  You don’t have to live with shoulder pain and limitation.  Give us a call and we will guide you to health.