Diagnosis and Treatment
Shoulder impingement is the application of excessive pressure, or compression on the rotator cuff.
Injury and excessive repetitive use of the shoulder, along with age and genetics may cause what is called the shoulder impingement syndrome.
It makes range of movement very limited and painful, and if not treated properly, can cause future shoulder problems.
What Is Shoulder Impingement?
Shoulder impingement is also known as painful arc syndrome.
Shoulder impingement is also known as supraspinatus syndrome, swimmer’s shoulder, thrower’s shoulder, rotator cuff impingement, subacromial bursitis, and rotator cuff tendonitis.
The rotator cuff is a group of muscles which assist in shoulder rotation and strength.
When a shoulder injury occurs, the most commonly affected muscle of the rotator cuff is the supraspinatas.
The rotator cuff muscles surround the shoulder joint, and if an injury occurs, the muscles respond by swelling.
Because the shoulder muscles are surrounded by bone, swelling causes the pressure with the muscles to increase, resulting in compression.
When compression occurs, there is loss of blood flow in the small blood vessels. When the blood flow decreases, the muscle will begin to fray, causing a great deal of pain when reaching up, or behind the back.
It will make any range of movement very limited and very painful.
If the injury lasts for a long period of time without treatment, the muscle can actually tear into two, like a frayed rope, resulting in a rotator cuff tear, and/or rupture of the bicep muscle of the affected muscle.
Causes of Shoulder Impingement
Repetitive overhead movements
The causes of shoulder impingement are most often related to repetitive overhead movements practiced in athletic activities such as swimming, throwing a ball, hitting a volleyball, serving in tennis etc.
There are also genetic factors which can contribute to shoulder impingement such as structural or anatomic abnormalities.
Aging and development of osteoarthritic spurs, or arthritis can narrow the space for the rotator cuff, causing it to be pressured or pinched.
Inflammation or instability in the shoulder also contributes to this syndrome, as well as any traumatic injury to the shoulder.
Shoulder Impingement Symptoms
You may experience gradual pain, eventually increasing in intensity, in the front or side of the shoulder, which is aggravated by reaching above, or behind the back.
Radiating pain down and into the upper arm may be experienced. Your range of motion may be decreased dramatically, and will be very painful.
You may experience weakness and difficulty raising your arm overhead or behind your back. Pain may interfere with your sleep, and it may hurt sleeping on the side of the affected shoulder. You may experience a grinding or popping sensation during shoulder movement.
Shoulder Impingement Treatment
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Always seek prompt advice from your doctor about your shoulder condition.
Conservative treatment would require you to protect your shoulder, and refrain from activities which trigger the pain. Resting, and stopping all activities which require repetitive shoulder movement is mandatory.
Ibuprofen or other NSAIDs may be used, along with [easyazon_link asin=”B000RBUE3A” locale=”US” new_window=”default” nofollow=”default” tag=”privat-20″ add_to_cart=”default” cloaking=”default” localization=”default” popups=”default”]ice packs[/easyazon_link] to relieve inflammation and pain temporarily.
Physiotherapy treatment may be necessary to improve range of motion, and to avoid stiffness and muscle atrophy. If the shoulder pain does not subside within a few days you must seek medical attention for a proper diagnosis and treatment. NHS Direct has more details.
Shoulder Impingement Diagnosis
Your physician will probably be able to ascertain by your medical history, limited range of movement, and a simple x-ray, if you are experiencing shoulder impingement syndrome, but there are other tests that make the diagnosis more definitive.
Ultrasonography, arthrography, and Magnetic Resonance Imaging (MRI) may also be used in order to be certain of diagnosis and treatment appropriate for shoulder impingement.
Treatments options may vary from simply resting the shoulder to arthroscopic surgery, depending on the severity of the shoulder impingement.
Shoulder Impingement Surgery
If the condition is really serious, shoulder surgery may be unavoidable in order to prevent further damage to the shoulder muscles.
If you let the pain go too long, you may have to have inflamed tissue and bone spurs removed from around the rotator cuff, a torn tendon re-attached, tissue transfers for large tears, or a shoulder replacement.
It is very important to seek medical attention before it becomes a matter of surgical repair.
Repetitive movements with an already injured shoulder can create many more problems within the shoulder structure. If you have a shoulder pain that just won’t go away, it is best to visit your doctor.
When the correct diagnosis is made, individualized physical therapy can be prescribed, based on any surgery performed and the condition of the bone, muscle, and soft tissue. This will make healing time quicker and less painful.
Avoiding Shoulder Impingement Surgery
Prompt treatment and physiotherapy may repair the effects of shoulder impingement before surgery is necessary so don’t delay getting treatment for shoulder impingement.
Always check with your doctor first, but once your condition has been properly diagnosed and treated exercising your shoulder regularly will help you get relief from shoulder pain.
Never repeat an exercise if you feel that it aggravates your pain. Stop the exercise immediately if it hurts.
Tim Allardyce DO MCSP SRP