A review of how shoulder impingement syndrome is handled by Dutch speaking physiotherapists

This research study does not do much to add to our collective knowledge of shoulder impingement therapies. Itwas a simple survey sent out to physiotherapists to collect information on how they treat patients with shoulder impingement. Shoulder impingement is a compression of a tendon in the shoulder. It is very common in people with overuse syndromes.

The shoulder functions as a ball and socket joint with over 10 muscles affecting how it moves, turns, rotates, elevates, depresses, and glides. Commonly with injuries we start having tightening and spasms of certain muscle groups that pull the ball and socket to a less ideal position. This is going to increase the chanceof tendon irritation and injury. This scenario is very easily described as between a bone and a hard place. With continued movement we produce irritation and tendon injury, leading leadingtopain and shoulder impingement.

Current standard treatment involves exercises to strengthen weaken muscles. Soft tissue work to decrease muscle spasms combined with stretching to enhance flexibility. The article did not define what type of soft tissue mobilization or manual therapy was utilized. As this is a vast difference in treatment. It also did not differentiate between trigger point therapy, massage therapy, active release, Graston Technique, or deeper myofascialtreatments on the affected shoulder muscles.

As with any shoulder injury it really comes down to loosening the tight muscles, strengthening the weak, and teaching the muscles how to work together again. Stabilization exercises that challenge the function and how the muscles work together should be incorporated with every shoulder treatment plan. There are some great exercises utilizing the exercise balland shoulder stability tools that will speed recovery. Simply sticking with basic rubber bands for internal rotation, external rotation, abduction, abduction, flexion, and extension is not the best treatment. It’s a starter treatment exercises only; and you should progress to more advance exercises when you are physically able to do so.

Below is the abstract from the studyfor your interest and reading. Shoulder stabilizer functional development is important fore decreasing shoulder pain and impingement syndromes. Massage therapy and physical therapy can be incorporated into many shoulder impingement treatment plans.

More information on therapeutic treatments utilizing PhysicalTherapy or Chiropractic can be directed to Google+.

Journal of Manipulative and Physiological Therapeutics

Volume 35, Issue 9 , Pages 720-726, November 20127

Evidence-Based Treatment Methods for the Management of Shoulder Impingement Syndrome Among Dutch-Speaking Physiotherapists: An Online, Web-Based Survey

FilipStruyf, PT, MSc, PhD, Willem De Hertogh, PhD, JorisGulinck, PT, Jo Nijs, PhD



The purpose of this study is to examine whether Dutch-speaking physiotherapists in Belgium report using evidence-based practice methods for the treatment for patients with shoulder impingement syndrome (SIS).


An online questionnaire, consisting of open-ended and multiple choice questions, was sent to Dutch-speaking members of therepresentative Belgian physiotherapists society that likely treated patients with shoulder pain. The electronic survey was sentto members of the Belgian Physiotherapists Society (AXXON) (n =3877). Therapists were asked to report interventions that they used for the treatment for patients with SIS. Survey responses were interpreted using current literature that supports various active treatments for SIS, including supervised exercise, home exercise, and exercise therapy combined with manual therapy.


A total of 119 (3%) of the AXXON members completed the online survey (68 men; mean age, 38 years). Sixty-one percent of the respondents were manual therapists, and 36% were sports physiotherapists. Exercise therapy was the most often reported therapeutic intervention (96.6%). Manual mobilization was most frequently reported for the treatment of SIS (94.1%), followed by postural training (85.7%) and stretching (76.5%). The remaining interventions were applied by less than 54% of the responders.


The results suggest that exercise therapy and manual therapy were reportedly used by most physiotherapists responding to this survey. These practices are in line with current evidence for the treatment of SIS.

© 2012 National University of Health Sciences. Published by ElsevierInc. All rights reserved. PubMed