What We Treat · Koh Samui

Shoulder Impingement Treatment in Koh Samui

Reaching overhead, sleeping on your side, paddling out or putting on a shirt shouldn't hurt. When it does, the problem usually isn't just the shoulder. At Body Tune Up in Bophut, we look at how your shoulder blade, upper back and rotator cuff are working together, find the link that's breaking down and fix it so you can lift, reach and train with confidence again.

It's a common problem for surfers, swimmers and tennis players, lifters and yoga practitioners, and anyone who spends long days at a laptop.

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Understanding it

What is shoulder impingement?

Shoulder impingement, often called subacromial pain syndrome, is irritation of the rotator cuff tendons and the bursa that sit in the small space at the top of the shoulder, under the bony tip of the shoulder blade (the acromion). When you lift your arm, those tissues need room to glide. If the shoulder isn't moving well, they get squeezed and overloaded, and they become sore and inflamed.

The name suggests something is being pinched by bone. In most cases, the real story is a rotator cuff that's been asked to do too much without the right support from the muscles around it. That's good news, because overloaded tendons respond very well to the right treatment and the right exercise.

How it shows up

Signs & symptoms

  • The painful arc

    Pain as you lift your arm out to the side, usually between shoulder and head height, that eases once your arm is higher or lower.

  • Pain reaching up or behind

    Reaching to a high shelf, washing your hair, hooking a bra or tucking in a shirt.

  • Night pain

    An ache when you lie on that shoulder, or one that wakes you when you roll over.

  • Ache down the outer arm

    A dull ache on the outside of the upper arm, sometimes with a feeling of weakness or catching as you lift.

The real cause

Why it happens — beyond the shoulder itself

Your shoulder joint depends on the shoulder blade underneath it. When you raise your arm, the shoulder blade has to rotate and tilt to keep the rotator cuff tendons clear. That depends on muscles like the lower trapezius and serratus anterior doing their job, and on an upper back that can extend.

When those stabilizers switch off, other muscles step in. The upper traps hike the shoulder, the pecs pull it forward and the rotator cuff ends up working overtime in a cramped space. Add a stiff upper back from desk work, a heavy block of paddling, swimming, serving or overhead lifting, and the tendons get irritated.

That's why we use NeuroKinetic Therapy® (NKT®) muscle testing alongside a full movement assessment. It shows us exactly which muscles are underperforming and which are compensating, so treatment goes to the cause, not just the sore spot.

Our method

How we treat shoulder impingement at Body Tune Up

  1. Functional Movement Assessment

    We look at how you raise, rotate and load your arm, and we screen your shoulder blade, upper back and neck at the same time. Orthopedic testing and NKT® muscle testing tell us what's irritated and what's driving it.

  2. Hands-on treatment

    Orthopedic and soft tissue massage, joint mobilization and NKT® release and activation to settle the irritated tissue and get the right muscles working again. Kinesiotaping can help support the shoulder between sessions.

  3. Corrective exercise & capacity

    Targeted rotator cuff and shoulder blade strengthening, upper back mobility and a progressive return to overhead loading, whether that's surfing, swimming, lifting or your yoga practice.

Tanny, physiotherapist

Your physiotherapist

Tanny — Physiotherapist & Orthopedic Massage Specialist

Tanny holds a BSc in Physical Therapy and brings more than ten years of clinical experience to Body Tune Up. She has trained in NeuroKinetic Therapy® directly with our director, Jory Serota, and she combines skilled orthopedic and soft tissue massage with her physiotherapy treatment. For shoulders, that means hands-on work that finds exactly where the tension and restriction are, followed by the exercises that keep them from building up again. She treats in Thai, English and German.

Your visit

What to expect

Your first session is mostly assessment and explanation, so you leave understanding why your shoulder hurts and what we're going to do about it. Wear a tank top or sports top so we can see and move the shoulder and shoulder blade. Bring any scans or reports you have.

Many clients feel a clear change in pain and range within the first few sessions. Tendons take time to rebuild strength, so lasting results usually come over several weeks of treatment and consistent home exercise. We'll give you an honest picture of your timeline after the assessment.

If your arm suddenly became weak or you couldn't lift it after a fall or injury, or your shoulder pain comes with chest pain, shortness of breath, fever or a hot, swollen joint, see a doctor first.

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Related conditions & services

FAQ

Shoulder Impingement — common questions

Do I need an MRI or X-ray first?

Usually not. A thorough hands-on assessment tells us a lot. If anything suggests a tear or another problem that needs imaging, we'll tell you and point you in the right direction.

Will I need an injection or surgery?

Most people don't. Research has shown that for many people with shoulder impingement, a well-structured exercise program gets results comparable to surgery. We start with treatment and exercise, and we'll refer you on if your shoulder isn't responding.

Should I stop training?

Usually you don't need to stop completely. We'll help you adjust what you're doing, often reducing overhead load for a while, so you can keep training while the shoulder settles and gets stronger.

Should I rest it or keep moving?

Keep moving within comfort. Complete rest tends to leave the shoulder stiffer and weaker. The goal is the right amount of the right movement.

Can Kinesiotaping help?

It can help support the shoulder and reduce pain between sessions. It works best alongside hands-on treatment and exercise, not instead of them.

Do I need a doctor's referral?

No. You can book an assessment directly.

Calm ocean waters off Koh Samui

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