Insights To Get You Moving

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DO THESE SCENARIOS SOUND FAMILIAR?

• You go to reach into the cupboard for a mug — sharp pain as you lift your arm.
• You hit a forehand on the tennis court – sharp pain as your arm crosses your body.
• You’re on the driving range, trying to get ready for the new season – “Wow, my shoulders are really messed up from the winter.”

If any of these situations sound familiar, you may be experiencing shoulder impingement syndrome. Shoulder impingement syndrome is usually described by a patient as a pinching or sharp pain in his/her shoulder as they lift their arm over head or across the body. Pain normally occurs at a specific arc of motion when the patient moves his/her arm, rather than at all times. In some cases almost all movement may  be pain-free, except for when you hit the sweet spot.

THERE ARE 2 CLASSIFICATIONS OF SHOULDER IMPINGEMENT SYNDROME:

1. Primary impingement involves bony structures, often bone spurs, pinching down on the rotator cuff tendons as they emerge from the shoulder blade, the scapula. Pain occurs when structural narrowing is combined with motion
2. Secondary impingement, on the other hand, results from poor movement of the shoulder, most often the scapula-thoracic joint {i.e. where the scapula moves along the thoracic spine}. Typically, physical rehabilitation focuses on pain free passive range of motion, rotator cuff strengthening, and scapular strengthening exercises. This approach ignores one key component of the scapulo-thoracic joint… the thoracic spine!

3 QUICK WAYS TO AVOID SHOULDER PAIN BY IMPROVING YOUR THORACIC SPINE

1. Watch Your Posture
Poor posture can cause shoulder impingement, especially if the body is slouched forward in a chairs for the majority of the day. Here is a good test. See how high you can raise your arms in front of you. Put your arms down. Now repeat, but this time slouch your upper back and see how high you can get. Noticeably less! This is a demonstration of how a lack of thoracic extension, inability to backward bend, and poor posture can alter shoulder mechanics.

2. Foam Roller
Improve thoracic extension using a foam roller (or a “peanut”: two lacrosse balls taped together) on the floor or against the wall. Work on bending backwards one segment at a time. Use deep breathing to relax musculature and improve motion.

3. Threading the Needle
The majority of your ability to twist/rotate actually comes from your thoracic spine, not your lumbar spine. Thus, thoracic rotation is key to most athletic activities involving arm swings. If you don’t have enough thoracic spine movement, you may “over swing”, utilizing more shoulder musculature and shoulder range of motion to generate power. A helpful exercise is called “Threading the Needle”. First, set up on your hands and knees. Initiate the exercise by reaching your arm along the ground between your opposite hand and knee, twisting the mid back until you stop. From here take a few deep breaths and repeat on the other side.

The physical therapists at Virginia Therapy & Fitness Center know that there is often more to treat than the site of pain. Your therapist will use functional assessment to find contributing dysfunctions that are often overlooked. In cases of patients with diagnoses of shoulder impingement, we never ignore the importance of the thoracic spine. Click here to schedule today or call 703.709.1116.