Treatment Options for Frozen or Separated Shoulders

The primary tendon affected in a shoulder impingement is the rotator cuff tendon, which is a tendon for the teres minor, infraspinatus, supraspinatus, and subscapularis muscles. These muscles contribute to overall joint stability and travel from your shoulder blade to the top of your humerus (arm bone), and are responsible for external rotation, internal rotation, and abduction.

The most common symptom of shoulder impingement is pain with overhead motions, such as throwing, catching, or hitting. Other symptoms include localized swelling around the shoulder joint, pain reaching behind your back, and general shoulder stiffness.

Most shoulder impingements resolve through noninvasive therapies, such as manual therapies, exercise, and anti-inflammatory medications. If these therapies fail to resolve the issue, a cortisone injection may be considered, which can help resolve the lingering pain and inflammation in the joint. If this therapy fails, then surgery may be considered. However, surgery is typically reserved for very severe shoulder impingements that do not resolve within two years.

You can prevent shoulder impingements by practicing good form during overhead movements, stretching the shoulder muscles regularly, and strengthening the rotator cuff muscles. Here are a few ways that you can reduce the chance of shoulder injury:

• Good warm-up
• Stretching
• Strengthen the rotator-cuff muscles
• Move correctly when performing sport-specific movements, such as throwing, hitting, or any movement that involves moving your hand over your head
• Limiting repetitive overhead movements

Treatment for shoulder impingement usually starts with a combination of rest and rehabilitation. It depends on the severity of the injury and the types of overhead motions required for daily activities, sports, or work. If the injury is more severe, surgery may be required to create more space in the shoulder joint. However, surgery is considered a last-resort and other interventions should be attempted before surgery.

Shoulder impingement is a chronic compression injury to the soft-tissue structures of the shoulder joint. When you move your arm overhead, the space between your humerus (arm bone) and the acromion (pointy end) of your shoulder blade shrinks, and the tendons running through that area from your rotator cuff can get irritated. Normally, this temporary compression does not lead to any injury, but consistently repeating overhead motions can lead to irritation and pain. If left untreated, the constant compression of the structures in the shoulder joint can lead to more debilitating effects and chronic shoulder pain.