It’s that time of year again when the days grow shorter, the leaves have fallen and shoulder patients are coming out of the woodwork.  Be it raking, overhead sports, snow shovelling or the general abuse of preparing homes for winter, shoulder problems seem to increase in the fall and winter months.

Shoulder pain can come in a wide variety of diagnoses including bursitis, tendonitis, arthritis or rotator cuff strain.  A common presentation of many of these shoulder pathologies is impingement syndrome.  Impingement Syndrome patients complain of pain at or near 90? of elevation due to the excessive compression of the rotator cuff tendon(s) and/or subcromial bursa under the subacromial arch.  These patients often have dull lateral arm/shoulder ache exacerbated by elevation of the arm into forward flexion or abduction.  A great deal of people will describe less pain above 120?, only to experience a sharp increase in pain upon lowering the arm through 90?.  Night time rest is often interrupted when they inadvertently roll onto the affected side or lie with the affected arm draped across their body in horizontal flexion.

There are many treatment options available for shoulder “impingement syndrome” including NSAIDS, cortisone, ice, acupuncture or even acromioplasty.  In my opinion and experience the best way to treat this biomechanical problem is with a biomechanical assessment and solution.  To identify why a person develops impingement syndrome is to identify how to treat it.  Often muscle imbalance, postural disturbances, scapular control issues, spinal restrictions, ergonomic problems or a combination of these factors are discovered.  Through proper education, exercise and manual (hands on) techniques most impingement syndrome patients can achieve relief.  Unfortunately, without biomechanical correction these shoulder problems can progress to rotator cuff degeneration, rotator cuff tears, osteoarthritis and permanent functional loss.

Please consider Therapeutic Solutions for your next shoulder impingement syndrome patient.  It would be my pleasure to provide the quality physiotherapy treatment and assessment required to resolve their problem and return to your patient pain free function.


Therapeutically Yours,


David Henschel,


Registered Physiotherapist

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