Why does my shoulder hurt when gardening?

Shoulder pain is common with gardening tasks, and the most likely cause is a condition called shoulder impingement. Here we will discuss how you can avoid shoulder impingement what to do if you think you may have it.

It’s that time of year people are flocking to their outside space and starting to prepare their gardens for the summer. Gardening is a great form of exercise but it is often underestimated how much strain it puts on your body and how easily you can injure yourself!

The Telegraph published an article in 2010 which stated “One in ten Britons has been injured when gardening, four times as many as those hurt on ski slopes”! One common area to injure when gardening is the shoulder.

The shoulder is a ball and socket joint, but the “socket” component is too shallow for the ball to fit inside it, so just rests against it. Think of a golf ball on a tee. This is held in place and kept stable by a group of four muscles called the rotator cuff, which attach to the top of your arm via a group of tendons (the attachment between muscle and bone).

Shoulder impingement

The space between top of the arm bone (humerus) and the bone on top of the shoulder (the acromion) is called the sub-acromial space. It’s pretty small, and is filled with the rotator cuff tendons, one of the tendons of your bicep muscle and a fluid sac called a bursa which helps to prevent friction.

This space is further narrowed when you lift your arms overhead. So if you are completing lots of overhead activity (such as hedge clipping and chopping) you could develop inflammation of your rotator cuff tendon (tendinitis) or your bursa (bursitis) as they catch or rub against the bones of your shoulder. This is known as shoulder impingement.

There are lots of other causes and contributing factors of shoulder impingement, such as:

• Shoulder blade muscle control

• Instability of your shoulder joint

• Weakness or tears of the rotator cuff muscles

• Some people develop “bony spurs” in their shoulder or have differences in the shape of their acromion bone

So if any of these factors are present, you may be more at risk of developing shoulder impingement. Bear this in mind if you have had a previous shoulder injury, as the muscle control and stability may not be 100%. This one of the reasons why effective rehabilitation after an injury is so important!

How do I avoid shoulder impingement when gardening?

As with most things, prevention is better than cure. Although First Line Physio is here to help rehabilitate your injuries, we would rather help you to AVOID THE INJURY IN THE FIRST PLACE. The problem with these injuries is that often you will be unaware of any pain during the aggravating activity. It may even be a day or two afterwards that you start noticing shoulder pain.

The best way to avoid shoulder impingement is to have an awareness that repetitive overhead movements can cause it. These are unavoidable for some gardening tasks, so it is important that you try and break these tasks up with other chores that don’t involve overhead movements. Chop and change tasks like digging, weeding and trimming so that you don’t spend hours doing the same thing.

If you start getting pain in your shoulders at any point, STOP THAT ACTIVITY AND REST. It’s not a case of no pain, no gain with this, and the more you do, the more inflammation you may cause.

Don’t do more than 1-2 hours of gardening if you aren’t used to it!

Try and take short breaks from gardening every 30-45 minutes

Try exercises to prevent shoulder injuries. You can try arm swings before gardening as a warm up, or shoulder blade squeezes during your gardening session to try and relieve pressure around this area.

How do I know if I have shoulder impingement?

One of the main signs of a shoulder impingement is shoulder pain when you lift your arm out to the side. It can also hurt to bring your arm behind your back and to lie on the affected side. There may be no pain at all when your arm is at rest by your side, as the “pinching” of the impingement tends to happen as the arm is raised.

However, many other shoulder conditions can mimic impingement and it’s important to speak to a physiotherapist to get a clear diagnosis. There are several tests that a physio can complete to check for an impingement. Physical examination from a physio for shoulder impingement has a 90% diagnostic sensitivity (chance of diagnosing you correctly).

Is there anything I can do for impingement?

If you think you may have shoulder impingement, the most important thing is to REST. Avoid further repetitive overhead movements. Try using your other hand for a couple of days to allow the tendon to recover.

Ice can help with pain and inflammation. Grab a bag of frozen peas, wrap them in a damp tea towel (this is more effective in lowering skin surface temperature) and put it on your shoulder for up to 10 minutes (less if it makes your shoulder numb). You can use ice several times a day, but make sure you leave at least 30-60 minutes between applications to restore normal blood flow.

If the pain does not improve within a few days, seek advice from a physiotherapist. You may have other contributing factors to the impingement, such as weakness and your physio can assess these and design an tailored exercise programme especially for you.

It’s important to treat an impingement early to prevent further complications. As the tendon rubs and catches on the underside of the acromion bone, this can cause damage, known as tendinopathy, or degenerative tears to the rotator cuff tendon. Impingement can also lead to an injury called frozen shoulder due to restricted movements. These can take more time to recover.

This is absolutely not written to substitute medical advice and it is always important to see a qualified health care professional for a formal diagnosis. If any of the exercises cause pain during or after the exercise, discontinue and consult a physiotherapist.

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