Shoulder Impingement (Subacromial Pain Syndrome) | Ep. 5
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- Опубліковано 17 тра 2024
- In today's episode of the podcast, we cover shoulder impingement, which is now called 'subacromial pain syndrome'. Shoulder impingement is an older diagnosis that was thought to be due to a pinching or impinging of the rotator cuff (supraspinatus) tendon, biceps tendon or subacromial bursa. Pain would typically occur when lifting the arm away from the body and overhead.
Over time, the name of this diagnosis was changed to ‘subacromial pain syndrome’ as it became evident that most people have some degree of impingement and many never develop symptoms. Like numerous other pain disorders, the pathophysiology of this disorder has been found to be more complex and should not be thought of as a simple, mechanical phenomenon.
If you would like to learn more about this condition, click this research article link.
www.ncbi.nlm.nih.gov/pmc/arti...
Serratus Anterior Muscle Exercises: • 3 Exercises for Scapul...
My book contains a comprehensive, 3-phased subacromial pain program that will teach you exercises to treat this issue on your own. Click the following Amazon link to learn more about my book and to order a copy. a.co/d/gLVxoa3
00:00 Introduction
01:28 What is Subacromial Pain Syndrome?
05:08 Common Signs & Symptoms
08:27 Prognosis
09:02 Postural Factors
09:59 Acute Rehab Strategies
12:40 Mobility Interventions
14:10 Resistance Training Interventions
17:22 Treatment Summary
18:06 Medical Interventions & Surgery
19:13 What Causes This Issue?
19:55 Is Surgery Necessary?
22:28 Conclusion
In today's episode of the podcast, we cover shoulder impingement, which is now called 'subacromial pain syndrome'. Shoulder impingement is an older diagnosis that was thought to be due to a pinching or impinging of the rotator cuff (supraspinatus) tendon, biceps tendon or subacromial bursa. Pain would typically occur when lifting the arm away from the body and overhead.
Over time, the name of this diagnosis was changed to ‘subacromial pain syndrome’ as it became evident that most people have some degree of impingement and many never develop symptoms. Like numerous other pain disorders, the pathophysiology of this disorder has been found to be more complex and should not be thought of as a simple, mechanical phenomenon.
If you would like to learn more about this condition, click this research article link.
www.ncbi.nlm.nih.gov/pmc/articles/PMC4062801/
Serratus Anterior Muscle Exercises: ua-cam.com/video/rj97r3yWAf0/v-deo.htmlsi=pW1QzOnnmBNtAobe
My book contains a comprehensive, 3-phased subacromial pain program that will teach you exercises to treat this issue on your own. Click the following Amazon link to learn more about my book and to order a copy. a.co/d/gLVxoa3
Thank you sir for giving a clear picture about shoulder impingement
You’re welcome! I’m glad the episode was helpful.
Hi Tom and Kirsten! I'm 61 and thankfully have never had any shoulder issues. I listened anyway. I do my exercises and stretches every morning. I get up at 4. I've been using the dumbbells too and I know I'm getting stronger. I have created a David Cassidy Playlist I enjoy!😅❤
Thank you for listening! So glad that you are starting to implement resistance training exercises with your dumbbells. There are so many benefits from resistance training (increased muscle mass, bone density, cardiovascular and brain benefits).
@@RehabScience brain benefits!??
@@kimalonzo3363 Cognitive benefits (improved memory and cognitive function) are associated with exercise, including resistance training. Here is a research article that explains some of these benefits. www.ncbi.nlm.nih.gov/pmc/articles/PMC10017453/
@@RehabScience that is incredible! I will read the article for sure! Even when I wasn't exercising I memorized 2 books of the new testament and have retained it! Who knows what I can do now!!!
I'm trying to buy the online rehab consultation but says out of stock ?
Thanks so much! I love your podcast - and your book. My daughter (Karly) is your biggest fan. I have had shoulder issues for over a year and will be starting over from page 1 in your book. My biggest pain is the 90°/90° with my right arm to the side and up. I can barely get it to 90/90. I’m secretly hoping I run into you guys when picking up Kara this week!😊 Thanks for all you do to help us all!
You’re so welcome! Please say ‘hi’ to Karly for me! The 90/90 position is often a challenging one for people. You might find the exercises in the videos below to be helpful. The first video has a shoulder external rotation stretch in the 90/90 position. The second video includes strengthening exercises with one being in the 90/90 position. The rotator cuff and frozen shoulder programs in my book also include these exercises.
ua-cam.com/video/GaiBcI4BelM/v-deo.htmlsi=mbqrbZCuF1XFp-Mc
ua-cam.com/video/jJo1CbgXb_A/v-deo.htmlsi=TUOMcoE7Exx9WTNN
This was really interesting. I’ve had issues doing overhead press for awhile (to the point that I stopped doing it). I wonder if this is the issue (though I did have an acute injury on either side; Crowdsurfer at a concert landed on me while my arm was overhead on one side and other side my front shoulder/pec area had a small pop and pain doing a 2 hand single dumbbell behind the head press).
Love your work btw! You deserve way more views.
Thank you for checking out this episode! I’m glad to hear that you found it to be interesting.
Based on what you described, your symptoms definitely could be related to subacromial pain syndrome. Because you felt a pop in one shoulder and the other shoulder experienced a trauma, you would also want to rule out a rotator cuff tear and a labral tear. Both of these would be identified with an MRI. If your symptoms aren’t super severe, then I would just focus on strengthening your rotator cuff and scapular stabilizers. I have a few videos on these areas and my book has more comprehensive programs. You can check my shoulder playlist here on UA-cam. Here is a link for my book, if you want to check it out as well.
a.co/d/fSLlVgY
Loved this! As an SPT, this was very helpful. Thank you very much 😊 i also know that it is really difficult to distinguish between subacromial impingement vs rotator cuff tendinopathy, and I was wondering if you came across any particular differences in the clinic yourself
So glad you enjoyed the episode! Unfortunately, the special tests for differentiating between those two issues aren't great. Plus, rotator cuff tendinopathy can create positive shoulder impingement signs. I don't worry too much about differentiating between them as the treatment strategy is pretty much the same in either case.
Interesting topic❤
Glad you enjoyed the episode!
How do I know if I have this or referred pain from cervical spinal stenosis C5 C6 issues? Thank you!
It’s definitely important to rule out referral from the neck. We have specific tests we would utilize if you came into physical therapy. Otherwise, you would want to pay attention to whether or not neck movements aggravate your shoulder symptoms.
You can also try the exercises in my cervical stenosis video below. If they help improve your shoulder symptoms, then you may be experiencing some referral from the neck.
ua-cam.com/video/NUd1BkRxni8/v-deo.htmlsi=Nadopfw5Lyv9y1cD
Super combinations Dr 👩⚕️
Can we fix all cases?
M
agree with your grading system- mild, moderate and severe. Impingement means might be because of many cases inside that specific space
Most cases do resolve with rehab. In some resistant cases, a cortisone injection may be helpful. In more severe cases, a rotator cuff repair or subacromial decompression may be necessary.
74 yr old female here with 2x rotator cuff tears the left being bone on bone and requiring reverse shoulder replacement asap. I have impingement from shoulder and down both arms. Left was only able to be moved to about 90 degrees. 2 days prior to scheduled surgery on 4/24/23, I had a digestive disorder requiring an ecrp with a temp stent placed. During the surgery the nusing staff log rolled me and possibly raised my left arm over my head to keep pressure off my arms when I was first asleep. I did warn them. As I said, my arm cannot be raised w/o severe pain. A day or so after the surgery I began to have more severe pain in my left shoulder and down the left arm. At this writing, I am only able to raise it to about 45 degrees w/o extreme pain even with pain pills. I have to have the temp stent removed in about 2 months before my shoulder replacement and am afraid the surgical nurses will give me another flare up How should they move someone like me to the xray gastro table without causing a flare up??? I think it's a sheet-slide from table to table.
Wow, I hope the nurses are more careful next time moving you! I am sorry you have so much pain.❤😢
Sorry to hear that your shoulder was made worse during this procedure. It can be very challenging to transfer a patient who has a shoulder pain issue going on. With individuals who have pain in overhead positions, we would usually tell them to keep their arm at their side with the elbow bent and hand on their stomach (sling position). However, this may not be ideal for the surgical staff. I would explain the situation to them and see if they can keep your shoulder in a different position.
@@RehabScience Thanks so much for the suggestion. It is their job to keep the patient safe and free from injury during transport and movement.
Can you please help me out, from my right leg i m unable to do lunges, and from same leg i m not able to do leg extention even 5 kg i cant lift... Please revert...
What do I do for frozen shoulder..
Been since October...now thawing but cannot reach up very far or behind back at all. Reached behind drivers seat to grab bag and pulled up to ftont seat...hurt but stopped then frozen a month later. Cannot put forearm flat against wall...elbow bows to right. Crazy!!! Thank you!!
Sorry to hear you are struggling with this issue. It can be a very frustrating and often requires a fair bit of patience. In the early rehabilitation process, cortisone injections can help speed up the healing process. Here is my UA-cam video that shows some of the most important mobility exercises to work on.
ua-cam.com/video/voxwcEraw6g/v-deo.htmlsi=4IbzBAmxA_M_5QJh
My book has a much more comprehensive frozen shoulder program that guides you through three phases of healing and has pictures of me doing the exercises. Here is an Amazon link for my book, if you want to check it out. a.co/d/jdpWSRo
@@RehabScience Thank you so much!! I subscribed. 😊
I've a supraspinatus tendon with some tears, bursitis, long head biceps tendon partially subluxed laterally all as a result of a fall which fractured the humeral head.
So yes, there's stress involved but the stress didn't cause it.
Oh, and also some tears in subscap tendon, bursitis at elbow and general agony.
And I never believe the stress component stuff. They always fall back on that when their physical theories don't quite fit with the imaging. If you ask me that's because the imaging isn't good enough. We just kid ourselves we are geniuses but in 300 years (if we haven't blown ourselves up) humans will look back and say our imaging techniques were a bit primitive.
And they may say the same about our understanding of biomechanics , but i feel it's more the imaging.
We rely way too much on biomechanics and imaging when trying to understand pain. Pain neuroscience research over the past 15-20 years has very much taught us that we need to widen our lens and consider all of the other factors (stress, emotions, beliefs, sleep, nutrition, etc) that can influence the pain experience.
I developed it in my right shoulder as I lost weight, no idea why but it's getting better.
Probably just a coincidence that it developed at the same time as the weight loss. I’m glad to hear your symptoms are improving!
@@RehabScience yeah, probably just coincidence, I have the luxury of working with both orthopedic surgeons and PTs and they gave some pointers and tips and now it's far better.
Класного парня отхватила👍
🙏🙏
Have you ever tried castor oil as an analgesic? I rub it on myself every night before bed. Just a suggestion!
I haven’t used it myself, but I have had patients that found that oil to be helpful.