home physical therapy SUBACHROMIAL BURSITIS:

Shoulder Impingement Rehabilitation Program

WHAT IS SHOULDER IMPINGEMENT?

Impingement is one of the most common causes of pain in the adult shoulder. It results from pressure on the rotator cuff from part of the shoulder blade (scapula') as the arm is lifted. The rotator cuff is a tendon linking four muscles - the supraspinatus. the infraspinatus, the subscapuiaris, and the teres minor. These muscles cover the "ball" of the shoulder (head of the humerus). The muscles work together to lift and rotate the shou der. The acromion is the front edge of the shoulder blade. It sits over and in front of the humeral head. As the arm is lifted, the acromion rubs or "impinges" on the surface of the rotator cuff. This causes pain and limits movement. The pain may be due to a "bursitis" or inflammation of the bursa overlying the rotator cuff or a "tendonitis" of the cuff itself. In some circumstances, a partial tear of the rotator cuff may cause impingement pain.

TREATMENT OPTIONS

Initial treatment is conservative. The doctor may suggest that you rest and avoid overhead activities. He or she might prescribe a course of oral non-steroidal anti-inflammatory medication. Stretching exercises to improve range of motion in a stiff shoulder will also help. Many patients benefit from injection of local anesthetic and a cortisone preparation to the affected area. The doctor might also recommend a program of supervisee physical therapy. Treatment may take several weeks to months. Many patients experience a gradual improvement and return to function.

Reach Over Your Head

Bring your arm over your head until you feel a stretch. Hold for a count of 10. Repeat 5 times a day.

With your good arm PUSH the cane across your body rotating the involved arm out to the side. DO NOT MOVE YOUR HANDS ON THE CANE and DO NOT GLIDE THE CANE THROUGH YOUR HAND. Try to keep your elbows close to your sides. When you start to feel a stretch hold the position for a count of 10. Repeat 5 times a day.

Cross Body Stretch

Grasp the elbow of the involved ami with your other hand.

Pull the involved arm across your body until you feel a stretch. Bold the stretch at each level to the count of 10. Repeat 5 times a day.

Repeal this exercise at any level where you feel tightness.

Reach Up The Back

Grasp a towel with both hands. The involved aim should be behind your back. PULL UP with your good arm until you feel u stretch. Hold this stretch for a count of 10. Repeat 5 times a day.

Acknowledgement: Material courtesy of Robert Klingman, MPT, OCS, FAAOMPT, Athalon Physical Therapy Tucson AZ