Impingement Syndrome: Pain in the shoulder joint

If the shoulder hurts when lifting the arm, the cause may be impingement syndrome. The impingement syndrome is a so-called bottleneck syndrome at the shoulder joint. This causes pain because the humerus abuts against a portion of the shoulder plate (acromion). This narrows the space for tendons and muscles and therefore hurts especially during exercise and exercise. Long existing symptoms can even lead to a tear of the tendons, which is then called rotator cuff defect or rupture.

Many technical terms describe the same disease

For the impingement syndrome, there are a number of other technical terms, but describe the same clinical picture. These include: subacromial syndrome, subacromial congestion syndrome, and subacromial impingement.

Causes of the pain

Typical of the impingement syndrome is that the symptoms, especially pain and limitations of movement, are not preceded by acute shoulder injury. Often, however, there is a long-term overload, for example by sports such as badminton, swimming or throwing sports or by professional activities.

These may in turn be causes of overload or dysfunction of the shoulder muscles, especially the rotator cuff. Another cause may be general age-related joint wear, such as osteoarthritis. Further causes of the pain are an inclination of the narrow joint, which favors the appearance of the impingement syndrome.

Physiotherapy and medication for therapy

For the treatment of the impingement syndrome, on the one hand, there are medicines on the other, as well as physiotherapy with muscle strengthening and cold or heat treatments. In acute pain is cold, relieving heat in chronic pain.

In general, when these symptoms occur, it is recommended to consult a doctor before any self-therapy. Subsequently, with an existing diagnosis, exercises can be learned with a physiotherapist and then continued at home. In order to support the muscles it can help to tap the overloaded muscles. The most important measure of treatment, however, is usually the strengthening exercises, which are rehearsed by physiotherapy.

Shoulder surgery may be necessary

For very severe pain, in which physiotherapy and drugs such as ibuprofen or acetaminophen no longer help, may also be necessary surgery of the shoulder. However, about four out of five patients affected by the impingement syndrome can be treated without shoulder surgery. With exercises and physiotherapy, sufferers can get a good grip on the pain.

If an operation is necessary, joint flexion is often sufficient to regain enough space in the joint space of the shoulder or to reconnect torn muscle tendons. In some cases, on the other hand, an open shoulder operation is necessary.

Exercises to strengthen the shoulder

We will introduce you to two exercises to strengthen and stabilize the shoulder muscles, which can be performed using a Thera Band. For both, the starting position is the same: sit comfortably, feet about 20 cm apart.

Exercise 1: Place the Thera Band under your feet and insert the ends into the right and left hands, which hang down on the side of your body. Then move the arms away from the body until they reach about 90 degrees. The direction in which the arms are led away from the body, can be varied, at best, a mixture between laterally away from the body and slightly forward, in front of the body. During the exercise, be sure to keep your thumb up and stand straight. Then go back to the starting position and repeat the exercise several times in succession.

Exercise 2: Bring your arms in a horizontal position so that the left upper arm, shoulder and right upper arm form a line. Then flex your arms at the elbow joint to create a 90-degree angle. Hold this position and count slowly to ten. Then, take your hands down to relax, count to five and start the exercise again. Also, vary the direction in which your forearms point, for example, in the first pass straight up, in the second pass rotated 90 degrees straight forward, and in the third pass straight down.

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