impingement of the subacromial bursa. Second Opinion/Excerises required

Hello All I was recently diagnosed with shoulder impingement. I obtained my injury from weight training, I did a shoulder session and felt a bit tight but no major dramas. The next day I was doing chest and whilst dumbbell pressing I lost all strength and mobility in my arm. No major pain started until some time after but I had to stop because of the lack of movement and strength (I kind of just knew something was wrong). I visited the physio who said I had shoulder impingement but only gave me 1 exercise to do with a tennis ball. I am still having difficulties nearly 2 months on. I am not training anymore and getting really frustrated now. I am no longer suffering with constant pain and shoulder weakness, just slight pinching in certain movements, and when I lie on the affected side it hurts. Could you please help with the following: -----------1-Exercises I could do to aide in my recovery -----------2- recommend any sports Physios either in Milton Keynes/Central London area with the correct experience. of the subacromial bursa.

I am afraid the mode of injury doesn't quite fit in with sub acrominal bursitis.

Add to this that sub-acrominal bursitis is most (90%) of time secondary to supraspinatus tendon irritation.

The correct management after 2 months of pain is take an x-ray.

There is also a need to do this because of presence of the joint subsiding under load. The AC joint also needs to be evaluated for separation and the capsule can also be investigated by taking measurements.

After this a correct management can be established.

If everything is ruled out and correct tendon or concomitant complications are correctly diagnosed - then ultrasound therapy and shock-wave therapy should remedy the condition in about 4-6 weeks with 10-20% improvement every week.

Hope that helps,

I am afraid we are based in Wimbledon which would, maybe, too far to travel for you.

Niall Marshall-Manifold D.C
wimbledon Chiropractic and Sports Injury Clinic

Hi Cmdo83. Can you please tell me which movements cause pain and which exercise your physio given you with tennis ball? nmarman also gives good advice. Hope you get better soon!

HI

Is no need to do xray, just do ultrasound scan.
y

you might have a partial rotator cuff tear! it's important to have a correct diagnoses

Yarok has mentioned ultrasound which can give a sound diagnosis of rotator cuff year but is almost impossible to give indication of grade of AC joint desperation or capsule tear.



Also you will see if there is any concomitant degeneration from chronic impingement or chronic AC joint instability. In truth I would do both - but to find someone good a ultrasound of the shoulder is hard.

Ultrasound imaging is a sonographer specific and even a good sonographer can find it hard to get a good image.

However the newer machines make getting a Image easier.

X-ray imagery has a better reliability then ultrasound but does come with small amounts of radiation (a shoulder X-ray will typically give as much radiation as spending 3-6 hours in London).


The best image combo would be MRI and x-ray both are highly reliable and give info both on joint condition and rotator cuff. If the supraspinstus shows high intensity on MRI the a ultrasound can be used to establish fullness of tear.

Hope that helps.