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Neck And Shoulder Pain: The Shoulder Blade And Impingement Syndrome And What To Do About It
The shoulder blade or scapula as we physio’s know it plays a very important part in the function of the shoulder joint.
This flat triangular shaped bone has the ability to move in lots of different directions and ultimately allows your arm to move properly
Now, to understand why the shoulder blade is important you must also understand a bit about the structure of the joint.
The best way to think of the shoulder joint is like a tennis ball on a golf tee as the ball of the joint is much bigger than the socket that it fits into.
Having a joint with a big ball and small socket means the shoulder has lots of movement however this also makes it very unstable, therefore it is extremely important to have the shoulder blade working properly to take the stress of the rotator cuff muscles that provide the support for the joint.
When physio’s speak about the rotator cuff muscles they are talking about 4 muscles that connect the shoulder blade to the upper arm.
These muscles pass in a very narrow gap between two bones that make up the shoulder and are under most stress when performing over head activities.
The reason for this is that when you reach up you shorten the space between these bones causing pressure on the muscle tendons, this is known as impingement.
The only way to avoid too much pressure on these muscle tendons is by training the shoulder blade to move properly and this is where physiotherapy comes in !
A client I had been treating recently had been suffering with shoulder impingement for the past 3 months. He was a keen tennis player and often played at least twice per week.
On assessment it was clear that his shoulder blade wasn’t doing its job exactly how it should be…
…It was not moving properly as he raised his arm up above his head therefore whenever he went for an over-head shot the space in the joint was too narrow causing impingement and pain.
The reason for this unnatural movement, as it is with most clients was due to two of the many muscles that attach to the shoulder blade not working as they should. These two muscles act to lift the top bone that makes up the shoulder joint to increase the space between the bones during overhead activities.
With the bone not lifting during over-head motions it meant more pressure was placed upon the rotator cuff muscles causing impingement.
A few simple exercises to activate these muscles along with manual physiotherapy treatment helped this client return to tennis pain free.
In order to determine whether a client has a problem with the function of their shoulder blade the physiotherapist will carry out a thorough assessment.
Normally an issue with the activation of these muscles causes the shoulder blade to sit in an asymmetrical position or even wing or tilt slightly.
From past experience a lot of the clients I see were already aware of the fact that their shoulder blade sticks out on one Side more than the other, normally due to a partner pointing it out!.
In order for this not to become a significant problem in the future it is very important to consult your physiotherapist who following an assessment can give specific advice and possibly treatment.
One simple exercise that you can perform at home to get the muscles that have a big influence on the shoulder blade movement functioning correctly is as follows:
* Lying on your front with your hands down by your side, slowly try and raise both shoulders off the floor lifting your arms off too so that your hands are only about an inch off the floor, whilst in this position try to reach with both arms gently down to your heels. Hold this position for 5 seconds and then repeat 10x reps, 3x sets, 3x per day.
Hope this advice helps anyone who is, or someone you may know that is suffering from shoulder pain or impingement.
Article written by Specialist Physio Jonny Corner.
Paul Gough is an internationally known Physio and Founder of The North East’s Leading Specialist Private Physiotherapy Practice for People in their 40’s, 50’s and 60’s, who want to keep healthy and active.
You might know Paul as an expert Columnist who writes weekly health articles for TWO of the North East's biggest daily Newspapers, The Northern Echo And The Hartlepool Mail, he is a regular Speaker at Industry Seminars around the globe and a Radio Personality, often heard on the BBC. Paul has been an expert guest on dozens of Radio shows and regularly interviewed in newspapers, magazines and trade journals all over the world, including the Guardian.
Paul’s background included working extensively in the Premier League with a Top Professional Football Team, and since quitting his job in Professional Football in 2007, his Physio Practice has become the fastest growing in the UK and biggest in the North East. So successful, that companies like BUPA, ASDA, The Vela Group And Coast & Country, repeatedly retain his Physio company's services to keep healthy their own staff and workforce. Paul Gough Physio Rooms is now a large multi-physio, multi clinic speciality practice in Darlington, Durham, Guisborough and Hartlepool.