Treatment Options for Frozen or Separated Shoulders

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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.

Preventing shoulder impingement involves practices that help maintain shoulder health, flexibility, and strength. Here are some strategies:

• Proper Posture: Maintain good posture, especially during activities that involve the shoulder. Slouching can alter the space where tendons move, potentially leading to impingement.
• Regular Exercise: Engage in exercises that strengthen your shoulder, especially the rotator cuff and scapular muscles. Strengthening these areas can enhance the stability of your shoulder joint, reducing the risk of impingement.
• Flexibility: Regular stretching can maintain or improve flexibility in the shoulder, which can prevent stiffness that could lead to impingement.
• Ergonomic Workspace: Adjust your workspace to avoid prolonged periods of reaching overhead or maintaining awkward positions, which can strain your shoulder over time.

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.