The shoulder is subject to different irritations, injuries, and conditions. Shoulder impingement is a common ailment but is often confused with other shoulder problems. Properly treating impingement syndrome needs proper diagnosis first. Most shoulder impingement cases do not require surgery. Conservative treatment like chiropractic focuses on pain reduction while increasing the range of motion. This is achieved with manual manipulation, soft tissue therapy, cold laser therapy, and spinal adjustments for shoulder posture realignment.  

Shoulder Impingement Symptoms

Shoulder impingement often gets confused with a pinched nerve or a rotator cuff tear. The symptoms can be similar, but the treatment options differ. This is why it’s important to know the specific shoulder issue presenting. This can be done by recognizing the symptoms and performing a shoulder impingement self-exam. Symptoms include:

• Pain when lifting the arm straight out.
• Pain when lifting the arm overhead.
• Pain along the outside of the shoulder, the front, back, or side.
• Dull throbbing pain.
• Trouble sleeping specifically individuals that sleep with their arm over their head.

Shoulder Impingement Self Exams

There are self-exams at home to help determine if it is in fact shoulder impingement. These exams are just to get a better idea, but a professional chiropractic diagnosis is recommended.  

Exam 1

• Take the hand of the affected arm and place it on the opposite shoulder, creating a V shape at the elbow.
• Keeping the hand on the opposite shoulder, raise the elbow straight out in front bringing it up toward the face.
• If pain presents in the shoulder while moving the elbow up, then shoulder impingement could be a possibility.

Exam 2

• Stand up with hands down at the sides.
• Turn the hand of the affected shoulder inward, so the thumb faces back instead of forward.
• Keep the thumb pointing backward, raise the arm straight up in front and over the head.
• Note if there is any discomfort or pain.
• Bring the hand back down to the side.
• Next, turn the hand so that the palm is facing forward.
• Again, raise the arm in an arc, ending above the head.
• If pain presents while raising the arm with the thumb back, but feel relief with the palm facing forward, it is likely a shoulder impingement.

Chiropractic Relief

If there is some sort of impingement different treatment options exist. Many doctors treat shoulder impingement with injections and pain management. Studies show that conservative treatment, like chiropractic, have shown positive results for shoulder impingement cases. Chiropractic improves joint function and mobility while treating the underlying root cause. A chiropractor will use a multi-approach depending on the cause. A combination of adjustments, anti-inflammatory protocols, and active release techniques can be used.  

Chiropractic Adjustment

One of the first things chiropractors look at is the spine. This is because poor posture, and slumping shoulders, can be a major contributor to impingement. Chiropractors perform a posture assessment and, if necessary a spinal adjustment to achieve proper alignment is the beginning to get the body back in balance.  

Anti-Inflammation Protocols

Next, is the shoulder itself. Deep tissue massage and anti-inflammation techniques like cold laser therapy or ultrasound can relieve pain, and reduce inflammation. Once the pain has decreased, the chiropractor will move on to active release techniques.  

Active Release Technique

Usually the result of the muscles or tendons becoming inflamed and irritated, the active release technique is used to separate any scar tissue from the soft tissue. The active release technique is performed with a combination of movement and manipulation. This increases healing through proper blood flow and circulation.  

Healing Naturally

Here is an example of a potential treatment plan. All treatment plans are different depending on:

• Individual health
• Activity level
• Medical history
• Age
• Injury

Rest and Pain Reduction

• The first step in healing is rest. Individuals will be recommended to cease any overhead arm activity and any activity that causes inflammation of the shoulder.
• Pain reduction treatment. This could be:

1. Ultrasound
2. Laser therapy
3. Massage
4. Other forms of pain relief and inflammation reduction

Adjustments/Alignment

• Chiropractic adjustments performed on the upper cervical spine, upper back, and shoulder area will address the overall cause.
• Posture assessments will determine if the spine needs adjusting and if it is a cause of the impingement.

Stretching Exercises

• A chiropractor or physical therapist will teach the individual stretching and strengthening exercises for the shoulder muscles.
• The exercises are also called shoulder impingement rehab protocols.

Rehab Protocol

The stretches and exercises are an essential part of the healing process. The specific exercises will depend on the individual’s specific treatment plan but are made to be gentle on the body without any special equipment. If you have any questions call our chiropractic and physical therapy clinic to talk to a trained professional.

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Body Composition

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Strength Training

Strength training is defined as a technique/method of improving the body’s muscular strength. This is achieved by gradually increasing the resistance force through the use of free weights, machines, or body weight. This means the body gets stronger and more capable of performing regular, work, and sports activities without experiencing weakness, fatigue, discomfort, and pain. Examples could include:

• Carrying groceries or children
• Moving furniture, household objects, etc.
• Running
• Jumping
• Other physical activities

Strength training has numerous benefits, including:

• Increased physical performance
• Improved blood pressure
• Improved metabolism
• Reduced fat mass
• Increased bone strength/density
• Improved cognitive ability
• Prevention and management of type 2 diabetes
• Improved cholesterol levels
• Reduction of pain associated with chronic conditions

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Garving, Christina et al. “Impingement Syndrome of the Shoulder.” Deutsches Arzteblatt international vol. 114,45 (2017): 765-776. doi:10.3238/arztebl.2017.0765 www.healthline.com/health/active-release-technique#benefits