What is Shoulder Impingement?
If you have been told that your shoulder pain with overhead movements is the result of “Shoulder Impingement Syndrome” the next questions are: “What is Shoulder Impingement?” and “How can get rid of it?”
Supraspinatus Tendon Impingement
1- What is Shoulder Impingement?
Shoulder Impingement Syndrome is typically diagnosed with orthopedic tests that closely resemble a poorly executed sumo deadlift high pull. Shoulder impingement is caused by the joints of your shoulder moving in a way that causes it to bind upon its own soft tissues. A single incidence easily becomes a chronic condition as the swollen and irritated soft tissues then become a likely pinch point for future impingement. The same mechanics are at work when you continually bite the same place on your tongue. This is a common problem for novice weight lifters and crossfit athletes who have recently made rapid gains in overhead strength without cultivating equal overhead stability and middle back flexibility.
The Sumo Deadlift High Pull puts the shoulder in the same position as the Hawkins Kennedy Test for shoulder impingement. Photo courtesy of becomethebull.blogspot.com
2- How do I get rid of it?
Your family practitioner will tell you to ice the shoulder, take 800mg ibuprofen/ day and to stop lifting heavy objects overhead. That is fine for the short-term, but the only way to resolve the condition is to address the faulty movement patterns within the shoulder that created the initial impingement. The process that we use at Sports Medicine Northwest is two-fold: 1- We address any motor imbalances that are identified in exam, and 2- We optimize joint centration. We achieve both of these objectives through corrective exercise prescriptions.
With shoulder impingement syndrome “Optimizing Motor Imbalances” can mean everything from treating a rotator cuff muscle injury to scapular dyskenisia and a rigid upper back. In the absence of an acute tissue injury, joint centration movements such as the kettlebell arm bar, turkish get-up, and the kettlebell windmill are useful for regaining joint centration. At Northwest Strength and Performance and at Sports Medicine Northwest, we acclimate the injured athlete to the kettlebell windmill with the banded version demonstrated below.
After initiating these movements under traction, overhead lifts are progressively reintroduced and weight is added. When progressive weight is increased, the athlete is often stronger and more stable than they were before their initial injury.
