Shoulder pain commonly occurs in people with Parkinson’s disease. The most common cause of shoulder pain is “impingement.” While shoulder impingement can occur in anyone, specific movement patterns and PD symptoms predispose people with Parkinson’s to impingement.
What is Shoulder Impingement?
Shoulder impingement is defined as “inflammation of the shoulder joint from repetitive activities.” This is often exacerbated by overhead reaching or increased lifting/activity and is usually a result of abnormal muscle activation. So, where does Parkinson’s come into play? The same muscles that contribute to shoulder impingement are often weak in people with Parkinson’s.
Impingement, and the pain associated with it, happens when the postural muscles in our mid back between our shoulder blades (middle trapezius, lower trapezius, and rhomboids) are not working correctly to stabilize our scapula. And some of our rotator cuff muscles (teres minor and infraspinatus) are not working correctly to depress the head of the humerus (the “ball” of the ball and socket joint). This causes the supraspinatus muscle to get pinched or impinged between the head of our humerus and the AC joint. Strengthening the muscles above can restore proper motion and decrease pain.
Additionally, when we have weak postural and core muscles, we tend to round our shoulders forward and slouch. This shortens our pectoral muscles, causing them to become tight, further compressing the joint and impinging the supraspinatus. With Parkinson’s, these muscles often become rigid, causing further tightness and rounded posture.
So, what can be done to address this?
Physical Therapy can help!
A Physical Therapist will provide a full assessment of your movement patterns. We can identify which muscles are tight and weak and prescribe specific exercises to correct the imbalances.
Strengthening weak muscles and stretching tight muscles allows the shoulder joint to move appropriately, decreasing compression and pain. Below are some simple exercises that can help with this:
Scapular squeezes. Pull your shoulder blades back and down. You should feel the muscles between those shoulder blades working and a slight stretch in the front of your chest.
Doorway pectoral stretch: Stand in a doorway with your forearm against the door jam. Then, lean forwards through the doorway, so your arm is stretched behind you. You should feel a stretch in the front of your chest.
Lay flat on your back: This will be our favorite (maybe). This can be extremely helpful in opening up the chest and letting the spine extend and stretch.