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Is there any way to avoid surgery for a shoulder impingement problem?

Shoulder impingement is a condition involving the entire shoulder complex. Some experts even say it starts from the ground up. It occurs when soft tissue structures get pinched as the arm is raised up over head or rotated. It is usually a sign that something is not quite right in the shoulder.

Many people have avoided surgery for a shoulder impingement problem. The first step is a proper examination. A sports medicine specialist (physician or physical therapist) can help you with this.

Understanding the anatomy, biomechanics, and kinetics of normal motion is essential in identifying what's wrong. Movement of the shoulder (including the scapula or shoulder blade) must be examined. Past injuries and any residual effects must be taken into account.The examiner will look for muscle weakness, imbalance, or contracture (shortening).

Once the problem and its origin are identified, then an appropriate treatment program can be established. Exercises to improve motion and strength may be prescribed. Sleeper stretches are often used to improve stiffness and tightness in the posterior shoulder.

Sleeper stretches are done lying on the affected side. The elbow is bent and the arm is forward at shoulder level. If you are on your right side, place your left hand on top of the right hand and gently guide the forearm down toward the floor. This exercise should also be done with the arm above and below shoulder height.

Depending on what the examiner finds, you may be given other stretches or exercises to do. A concerted effort over four to six weeks should bring relief from your symptoms. If you are still having significant locking or catching of the shoulder during movement, then surgery may be needed.

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