Shoulder injuries are extremely common in the athletic as well as non-athletic population. Most shoulder injuries are the result of long term microdamage to the rotator cuff. It is common for me to see rotator cuff issues in people who perform repetitive over the head activity like throwing, swimming or lifting weights. In fact, in the weight lifting population shoulder injuries are dominant because certain exercises place your shoulder in a biomechanically incorrect position. Your average gym goer is there to stay fit not necessarily build huge muscles and compete in bodybuilding contests. However, in their attempt to stay fit they perform the very same exercises employed by bodybuilders. These exercises may be good for building muscle but are also good at placing your shoulder in high risk positions.
Some of the exercises that place your shoulder in high risk positions are benchpress, incline bench press, overhead shoulder press, lateral raise and behind the neck pulldowns. These exercises place your shoulder in an abducted and externally rotated position with maximal stretch on the glenohumeral ligaments. This is a high risk position and can result in strain to the rotator cuff as well as overstretching your shoulder ligaments. This results in stage 1 shoulder instablity and impingment syndrome.
Impingement Syndrome
Impingement syndrome is the result of long term abnormal stress on your shoulder. You may only feel it as a twinge here or there early on. Then your shoulder may hurt if you sleep on it or pick something up the wrong way. Then it starts to progress to hurting while you hold a steering wheel or blowdry your hair. What you thought was no big problem is becoming a big problem. Your doctor took an X-ray and said nothing was wrong but prescribed you some Motrin anyway. It seemed to help at first but now the pain is present most of the time. Your doctor sent you to physical therapy but that did not help or even made it worse. Does this sound familiar? First, X-ray shows bone not soft tissue so the x-ray was useless. An MRI would have been useful though. The antiinflammatory your doctor prescribed you did a good job masking the pain but it is not a healing drug. Your injury worsened because nothing was actually done to reverse the injury. Now the physical therapy. Exercising an injured muscle and causing furthur injury is never a good idea. I am often baffled when a patient tells me they went to PT and were worse after. YOU DO NOT EXERCISE AN INJURED MUSCLE! If left to your own device you would not do it but since the PT told you to you did and now it is worse. Now it has progressed from stage 1 Impingment Syndrome to Stage 2.
Stage 2 impingment syndrome results in small microtears to your rotator cuff muscle. The pain is now constant and you activities that require shoulder movement are severely limited. This is a critical phase of the injury when it can still be reversed with the proper treatment and understanding of the condition. By modifying your activity and exercise routine combined with our progressive treatment protocols your condition can be reversed thus avoiding surgery. If you allow this condition to continue it will progress to stage 3 Impingment Syndrome
