Physical Therapy

1. Physical Therapy Recovering from Shoulder Impingement in Athletes By Nate Engel

2. What is Physical Therapy? • Physical Therapy helps injured individuals recover through various stretches and exercises • Allows patients to learn about their injuries while progressively treating them.

3. Who are Physical Therapists • Extremely educated, health professionals who help improve mobility and reduce specific pain. • Can also educate their patients on how to achieve optimal health benefits

4. Physical Therapy Settings • Private practices • Hospitals • Nursing homes • Outpatient clinics • Schools • Sport facilities http://www.apta.org/AboutPTs/

5. Common Injuries and their therapy Top 10 Sports Injuries #3 Shoulder Impingement

6. Shoulder Anatomy The Rotator Cuff Muscles (SITS) Supraspinatus Infraspinatus Subscapularis Teres Minor

7. Importance of SITS Muscles • The SITS muscles function to allow movement in the glenohumeral joint • Keep the humeral head in place during overhead rotations

8. What is Shoulder Impingement • When the SITS muscles become weak and overworked, they stretch • This opens up room in the shoulder joint, allowing the humerus head to move freely • When moving freely, the bone impinges certain tendons causing extreme pain http://sportsinjuryhandbook.com/injuries/index.html

9. Effects of Shoulder Impingement • Extreme pain in shoulder joint • Decreased mobility • Weakness of Shoulder Muscles • Possible rotator cuff tear http://www.medicinenet.com/impingement_syndrome/page2.htm#what_are_the_symptoms_of_shoulder_impingement_syndrome

10. Causation • Any repetitive over the head movements can cause shoulder impingement • Repetitive lifting • Painting • Construction • Swimming • Tennis • Baseball http://orthoinfo.aaos.org/topic.cfm?topic=a00032

11. Where it Occurs most frequently • Tennis players • Baseball Pitchers • Swimmers http://www.sportsmed.org/uploadedFiles/Content/Patient/Sports_Tips/ST%20Shoulder%20Impingement%2008.pdf

12. Treatment • Surgical • A small incision is made • Shave off a tiny portion of the acromion process • Allowing a pain free movement in the shoulder joint • Rehabilitation program begins • Conservative • Rest and avoid overhead activities • Anti-inflammatory drugs • Stretches to increase flexibility • Muscle strengthening exercises http://www.shouldersurgeon.com/shoulder_impingement/

13. Recovery time • The conservative path can vary based on the persons rehab program and motivation to get better. • Surgical path is anywhere from a few weeks to several months. http://www.shouldersurgeon.com/shoulder_impingement/

14. Athletes with Shoulder Impingement Kerri Walsh – Olympic Gold medalist – Beach Volleyball Dwight Howard – Center for the LA Lakers J.D. Drew – Former right fielder for the Boston Red Sox

15. Stretches Triceps Stretch Codman’s Pendulum Swings Horizontal Adduction Stretch Internal Rotation Stretch http://www.athleticadvisor.com/images/Acrobat/Impingement.pdf

16. Stretches Cont.. External Rotation • Chest and Biceps Stretch Standing Adduction Stretch http://www.athleticadvisor.com/images/Acrobat/Impingement.pdf

17. Exercises to Strengthen SITS muscles • Seated Dips • Active Flexion Bent over rows http://www.athleticadvisor.com/images/Acrobat/Impingement.pdf

18. Exercises continued Shrugs Supine Press Towel Squeeze http://www.athleticadvisor.com/images/Acrobat/Impingement.pdf

19. Benefits of SITS strength • Increased range of motion • Decrease of injury • Enhanced specific sport performance • Allows for optimal shoulder strength • Optimal shoulder flexibility

20. Prevention of Shoulder Impingement • Focusing on the following areas will help to prevent Shoulder Impingement Syndrome • Flexibility • Core stability • Rotator cuff strength • General strength • Specific sport technique http://www.shoulderdoc.co.uk/article.asp?article=1370