Shoulder Rehabilitation For Impingement Syndrome

holding shoulder

Shoulder rehabilitation with patients diagnosed with impingement syndrome are successfully treated without surgery.

By definition shoulder impingement syndrome is when the tendons and bursa are compressed from the bones of the shoulder. With this condition pain is persistent and daily activities are affected such as reaching overhead or putting on a shirt.

If the condition is not treated inflammation will settle into the joint and can start to thin or tear the rotator cuff musculature. Weakness of the shoulder makes it difficult to elevate the arm.

Here we will examine the ways that a physical therapist helps patients recover with shoulder impingement syndrome.

The Acute Stage

External RotationThe first stage of the syndrome as well as one of the most important stages for shoulder rehabilitation intervention is known as the acute phase. During this time the symptoms of the ailment appear quickly, reducing the ability to move or raise the shoulder and causing sharp pain. While many people will seek to immobilize the shoulder believing it to be a minor injury, it is crucial to begin the shoulder rehabilitation with the aid of a physical therapist immediately.

The physical therapist will use modalities such as ultrasound, electrical stimulation or cold laser to decrease the acute pain and inflammation. The therapist starts mild passive ROM exercises, pulley and shoulder wheel apparatus to the point of pain. The patient is given a home program usually of Codman’s (arm circles) and wall climbing.

The Advanced Treatment Stage

wall climbingThis stage allows the physical therapist to begin treating the shoulder aggressively because the acute pain is reduced.The first step is intense passive stretching which gets the shoulder beyond the range that is  considered painful. Aggressive stretching prevents further loss of motion and disuse of the arm. Shoulder rehabilitation during this time has the therapist relax the shoulder with mild heat, stretch and then apply cold. The cold application decreases the chance of the shoulder getting inflamed and swollen. from the aggressive movements. also uses heat and cold therapy to help the healing process.

If the patient is making adequate progress in regaining use of the shoulder then the therapy will continue as planned. If there are difficulties, other steps have to be taken.

Treatment Stage for Ineffective Physical Therapy

shoulder injectionSometimes physical therapy may not be enough to counteract the impingement syndrome, requiring a different form of shoulder rehabilitation. With the physical therapist consulting with the orthopedist the option here is injections of corticosteroids. This may be done at the behest of the patient in the acute stage or by recommendation of the therapist during the treatment stage. Patients who are not responding to therapy can have this injection, and are usually able to complete the normal course of therapy as a result.

The Maintenance Stage

The final stage for shoulder impingement syndrome is based around continued therapy after the symptoms decrease. This usually takes place within six months and the emphasis in this stage is strength training using weights to help the patient return to full function.
These four stages of treatment are important for those who suffer from shoulder impingement syndrome. While not much is known about the causes, effective treatment is available. It is important to remember that qualified physical therapists will offer the best shoulder rehabilitation solutions.