SHOULDER IMPINGEMENT PROTOCOLS
The most commonly diagnosed condition of the shoulder is impingement syndrome. In this situation, poor mechanics of the glenohumeral joint, leads to impingement of the subdeltoid bursa and supraspinatus into the acromion. Symptoms in patients typically presents as pain to the lateral aspect of the shoulder and arm, that increases with flexion, abduction or external rotation. The main causes of shoulder impingement in patients are lack of rotator cuff strength, decreased capsular mobility, tightness in the pectoralis minor, and anterior shoulder posture. Chronic shoulder impingement can lead to rotator cuff tendinopathy, bony changes and subacromial bursitis. Current medical treatment options typically employ corticosteroid injections and physical therapy.However, physical therapy isvastlyunderutilized in a comprehensive treatment approach. A recent study in the Annals of Internal Medicine that focused on 215 patients, showed that physical therapy was just as effective as corticosteroid injections. Furthermore, combinations of these two methods resulted in the most improved outcomes for function and pain. When it comes to medical management of your patients with shoulder pain, corticosteroid injections and physical therapy should be prescribed together for best results. Physical therapy focuses on restoring correct strength, joint biomechanics and proprioception to the shoulder complex, resulting in lasting outcomes. For maximum results for your patients with shoulder pain, prescribe Recovery Physical Therapy today. Source: Coombes BK, Vicenzino B. Pragmatic Study of Corticosteroid Injections and Manual Physical Therapy for the Shoulder Impingement Syndrome. Ann Intern Med. 2014;161:224-225. doi:10.7326/M14-1405
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