Like most other joints in the body, the shoulder is subject to different irritations, injuries, and issues. Shoulder impingement is common, but it’s also often confused with other shoulder issues. In order to properly treat impingement syndrome, you must first identify it as such.
Most shoulder impingements do not require surgery. Conservative treatments, like chiropractic care, aim at reducing pain while increasing range of motion. This is usually done with manual manipulation, soft tissue therapy, cold laser therapy, and spinal adjustments for posture correction.
Shoulder Impingement Symptoms
Sometimes a shoulder impingement is confused with a pinched nerve in the shoulder or a rotator cuff tear. While the symptoms of these may be slightly similar, the treatment options tend to differ. This is why it’s important to know what specific shoulder issue you’re suffering from.
You can do this by knowing the symptoms and by performing a shoulder impingement test. The symptoms of shoulder impingement syndrome include:
- Pain when lifting the arm straight out from the body.
- Pain when lifting the arm overhead.
- Pain along the outside of the shoulder, on the front, back, or side.
- A dull, throbbing pain of the shoulder.
- Trouble sleeping (especially if you sleep with your arm over your head).
Shoulder Impingement Test
There are several tests you can do at home to help determine if you do in fact have shoulder impingement. However, these tests aren’t guaranteed accurate. They should simply give you a better idea if you should see a professional or not. You won’t know for sure if you’re suffering from shoulder impingement until a medical professional diagnoses you.
Test 1
Step 1: Take the hand of your affected arm and place it on your opposite shoulder. This will create a V shape at the elbow.
Step 2: Keeping your hand on your opposite shoulder, raise your elbow straight out in front of you, bringing it up toward your face.
Step 3: If you feel pain in the shoulder while moving the elbow up, you likely have shoulder impingement.
Test 2
Step 1: Stand up with your hands by your sides.
Step 2: Turn the hand of the affected shoulder inward, so your thumb is facing back instead of forward. (Internal rotation)
Step 3: Keeping the thumb pointing backward, raise the air straight up in front of you and over your head. Note any pain or discomfort.
Step 4: Bring the hand back down to your side.
Step 5: Now, turn your hand so that your palm is facing forward. (External rotation)
Step 6: Once again, raise your arm in an arc, ending above your head.
Step 7: If you feel pain while raising your arm with the thumb back, but feel relief with the palm facing forward, you likely have shoulder impingement.
Can a Chiropractor Fix Shoulder Impingement?
If you do have some sort of impingement, you may be looking for treatment options. Most physicians treat shoulder impingement with injections and pain management, with less than ideal outcomes.
Studies have shown that conservative treatment, such as those performed in chiropractic care, have shown favorable outcomes among shoulder impingement cases. Not only does chiropractic care improve joint function and mobility, but it also treats the underlying issue.
As a result, the majority of shoulder impingement cases can be treated with chiropractic care. However, some extreme cases may require surgery after conservative options have been exhausted.
How a Chiropractor Fixes Shoulder Impingement?
Chiropractors use a multifaceted approach to healing shoulder impingement. In fact, chiropractic is also an effective treatment for a pulled shoulder and other rotator cuff issues. Treatment varies depending on the cause of the impingement, but many chiropractors use a combination of adjustments, anti-inflammatory protocols, and active release techniques.
1) Chiropractic Adjustment Shoulder Impingement
One of the first things chiropractors look at to treat shoulder impingement is your spine. Yes, you read that right. Poor posture, and the slumping of the shoulders, can be a major contributor to shoulder impingement. As a result, chiropractors often do a posture assessment and, if needed, a spinal adjustment to get things in proper alignment.
2) Anti-Inflammation Protocols
Next, your doctor of chiropractic will often focus on the shoulder itself. Deep tissue massage and anti-inflammation techniques like cold laser therapy or ultrasound can help relieve pain, reduce inflammation and begin to heal the impingement.
Once your pain has decreased, your chiropractor will likely move on to active release techniques.
3) Active Release Technique for Shoulder Impingement
Since shoulder impingement is the result of the muscles or tendons of the rotator cuff becoming inflamed and irritated, active release technique is a common course of treatment. ART for short, this technique is used to separate scar tissue in the soft tissue of the body.
Active release technique is usually done with a combination of movement and manipulation. It promotes healing through blood flow and circulation.
ART is not ideal for everyone. It’s most often used on athletes such as swimmers and baseball players, or anyone who uses overhead shoulder movements on a regular basis. Your doctor of chiropractic can determine if ART is right for you.
Healing Rotator Cuff Impingement Naturally
As mentioned earlier, chiropractic treatment for rotator cuff injuries will vary depending on the cause and extent of the injury. But, here is an example of one such treatment plan. Yours may be different depending on your health, activity level, medical history, age, and injury.
It’s important to mention here that shoulder impingement and rotator cuff impingement are referring to the same thing for the purposes of this article.
a) Rest and Pain Reduction
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- The first step in healing rotator cuff impingement is often rest. The patient will be asked to cease any overhead activity and perhaps even any activity that will cause pain in inflammation of the shoulder.
- In addition to rest, the patient will likely undergo some form of pain reduction treatment. This may be ultrasound, cold laser therapy, massage, or some other form of pain relief and inflammation reduction.
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b) Adjustments
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- Chiropractic adjustments to the upper cervical spine, the upper back, and the shoulder area may help to address the overall cause of the impingement.
- Posture assessments may be used to determine if the spine needs adjusting and if posture is a cause of the impingement, as it is in many patients.
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c) Manipulation, Movement, and Mobilization
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- When the shoulder is in a place to begin the healing process, the chiropractor will likely decide on some combination of manipulation and mobilization.
- Soft tissue manipulation, like described above in regards to Active Release Technique, may be used.
- Shoulder mobilization may be used to reduce pain and increase range of motion.
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d) Stretching and Exercising
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- Next, the doctor of chiropractic or a physical therapist may assist the patient in stretching and strengthening the shoulder muscles to prevent future impingement.
- These stretches and exercises often focus on the muscles around the shoulder. These exercises are sometimes called shoulder impingement rehab protocols.
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Shoulder Impingement Rehab Protocol
The stretches and exercises you are assigned are some of the most important parts of the impingement healing process. While the doctor of chiropractic may demonstrate them for you at the chiropractic office, your job will be to continue them at home between sessions.
The specific exercises will depend on your specific treatment plan, but they’re typically fairly easy to do without any special equipment. Following the rehab protocol will ensure that you stay pain-free and avoid future impingement.
If you have any questions about shoulder impingement or recovery, call our chiropractic and physical rehab therapy clinic in Anchorage to talk to a trained professional.
We’re here to help, so don’t hesitate to call!
Resources:
https://www.sciencedirect.com/science/article/abs/pii/S0161475404002362
https://www.tandfonline.com/doi/abs/10.3109/09638288.2014.907364
https://www.healthline.com/health/active-release-technique#benefits
https://www.jospt.org/doi/abs/10.2519/jospt.2000.30.3.126
