Shoulder impingement is a very common cause of shoulder pain. Impingement occurs when the humerus impinges on the acromion of the shoulder, reducing the subacromial space (SAS). Impingement may result from structural causes such as bony deformation of the acromion, or as a functional result of shoulder instability and weakness. While therapeutic exercise is a standard treatment for functional impingement, no gold standard rehab protocol exists.
Dr. John Kuhn of Vanderbilt Sports Medicine in Tennessee published a systematic review of exercises used to treat shoulder impingement. This review of 11 randomized controlled trials strongly suggests that exercise improves symptoms in patients with impingement syndrome. Dr. Kuhn concluded that exercise was as effective as surgery in treating shoulder impingement and a home program can be as effective as supervised exercise.
His review, published in the Journal of Shoulder and Elbow Surgery, provided several suggestions for an impingement rehab protocol based on the literature:
- 1. Exercises should include daily range of motion exercises and stretching
-
2. Scapular and rotator cuff strengthening with Thera-Band elastic resistance bands should be performed 3 times a week for 3 sets of 10 with a progressive increase in resistance and repetitions to 3 sets of 20. Specific exercises are listed below:
Shoulder impingement is a very common cause of shoulder pain. Impingement occurs when the humerus impinges on the acromion of the shoulder, reducing the subacromial space (SAS). Impingement may result from structural causes such as bony deformation of the acromion, or as a functional result of shoulder instability and weakness. While therapeutic exercise is a standard treatment for functional impingement, no gold standard rehab protocol exists.
Dr. John Kuhn of Vanderbilt Sports Medicine in Tennessee published a systematic review of exercises used to treat shoulder impingement. This review of 11 randomized controlled trials strongly suggests that exercise improves symptoms in patients with impingement syndrome. Dr. Kuhn concluded that exercise was as effective as surgery in treating shoulder impingement and a home program can be as effective as supervised exercise.
His review, published in the Journal of Shoulder and Elbow Surgery, provided several suggestions for an impingement rehab protocol based on the literature:
-
1. Exercises should include daily range of motion exercises and stretching
-
2. Scapular and rotator cuff strengthening with Thera-Band elastic resistance bands should be performed 3 times a week for 3 sets of 10 with a progressive increase in resistance and repetitions to 3 sets of 20. Specific exercises are listed below:
| Rotator Cuff Exercises with Thera-Band Band |
Scapular Exercises |
| Internal Rotation at 0 External Rotation at 0 Scaption
Flexion
Extension |
Chair PressPush-up PlusUpright Row with Thera-Band Band |
-
3. Use manual therapy techniques with exercise interventions. Ultrasound is of no value in treating impingement syndrome.
-
4. Patients should receive supervised exercise 2 to 3 times a week with manual therapy; patients who no longer need manual therapy and are proficient in exercise programs can perform their exercises at home.
These guidelines can help clinicians develop evidence-based rehabilitation protocols for shoulder impingement. Obviously, some modifications may be necessary based on the individual patients problems and goals. Thera-Band elastic resistance bands are an important component of both in-clinic and home-based exercises for shoulder impingement.
REFERENCE: Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg. 2009 Jan-Feb;18(1):138-60.
$0.00