Shoulder pain from impingement and rotator cuff injuries are among the most common complaints I hear from my clients, old and young alike. Now, while I think it is imperative to get nagging injuries properly diagnosed by a qualified physician (such as an orthopaedic surgeon or sports medicine doctor), it’s useful to know what can cause this sort of pain and how to minimize the symptoms on your own (and perhaps even fully address the problem in the process).
Shoulder impingement refers more specifically to rotator cuff tendinitis (inflammation of the tendons that make up the rotator cuff) or shoulder bursitis (inflammation of the bursa that surrounds and protects those tendons). The shoulder joint is very unique in that it has by far the most mobility (range of motion) of any joint in the human body, which is due to the relatively unsupported structure of the joint. However, because of this, any inflammation of the tendons or bursa in the area are easily noticed and hard to avoid once present.
Because several bones, muscles and ligaments all coalesce in this area, the capacity for something to go wrong is a lot higher than in other areas of the body. On top of that, the fact that all these bones meet together means that the space between the bones is relatively small, and any inflammation of the soft tissue within the joint can cause the bones to pinch the tissue during movement. It shouldn’t be too difficult to see why pinching your tendons and bursa between two hard bones is going to hurt!
If you are active, the chance that you will experience shoulder pain at some point in your life is very high. Luckily, the pain is usually an issue of inflammation, meaning that the standard “RICE” sports treatment method is effective at improving the symptoms. RICE stands for:
- Rest: try not to perform whatever specific exercises, movements, work tasks, etc. exacerbate the problem.
- Ice: cold will reduce the swelling and numb the area, reducing pain. Both are good in this situation.
- Compress: this doesn’t apply so well to the shoulder joint, so in place of this I like to add in taking an NSAID, typically either ibuprofen or naproxen sodium. These, like icing, help to reduce inflammation and block pain.
- Elevate: another step that doesn’t make too much sense with the shoulder joint, considering it’s already near the top of the body. Avoiding positions where your shoulders are lower than your hips (particularly if you are supporting your weight with your arms) is a good rule of thumb though.
Personally, I tend to use the acronym “RIP” instead, which stands for rest, ice and pills… much more applicable to our situation. Reducing pain is only one addressing one part of the puzzle though, and in order to avoid similar issues in the future, one needs to increase the strength and stability of the shoulder joint through a combination of rehabilitative exercises and stretches.
My favorite exercise to perform on my clients (and the most effective from my experience) is the lateral shoulder rotation. The best way to do this is to perform as many repetitions as you can with the intact shoulder till you start feeling an intense burn. Whatever number you get to, this is your goal for your problem shoulder. You will notice that when you switch to your problem shoulder, you will not be able to perform NEARLY as many repetitions before the burning sensation begins. Each day, aim to increase your effort until you’re able to do the same number of rotations with both shoulders.
As for stretches, I like to perform a subscapularis stretch as well as a fairly unconventional and morbidly-named (but highly effective) movement called a shoulder dislocation. Just make sure you start off slowly with these and progress very gradually. These have the potential to greatly increase your range of motion, but if rushed can actually cause more problems than you had in the first place.