Shoulder impingement is a common cause of shoulder pain and results from pressure on the rotator cuff. The rotator cuff consists of four small muscles: the supraspinatus, infraspinatus, subscapularis and teres minor.
The function of the rotator cuff muscles is to lift and rotate the shoulder joint. The front edge of the shoulder blade is called the acromion. When the arm is lifted, the acromion rubs on the surface of the rotator cuff resulting in impingement, pain and limited range of motion.
Risk Factors for Shoulder Impingement
People who play overhead sports, such as swimming, volleyball, baseball, softball and tennis, are at risk for shoulder impingement. Others involved in repetitive overhead activities can also complain of pain associated with impingement.
Symptoms of Shoulder Impingement
Initially, symptoms may be mild, however, patients may eventually experience minor pain during activity as well as at rest. During activity, radiation of pain to the side of the arm, sudden pain with lifting and reaching, and pain with throwing, may result.
Local swelling and tenderness, along with pain and stiffness, is common when lifting the arm. Pain may also occur when lowering the arm after it has been elevated. Night pain may begin over time and the patient may experience increased difficulty with certain activities, such as buttoning a shirt or zipping up a jacket. In some severe cases, complete loss of motion is seen.
Diagnosis and Treatment of Shoulder Impingement
For the treatment of shoulder impingements, Gwinnett Medical Center–Duluth first takes X-rays to determine if additional testing, such as MRIs, will be required to make a proper diagnosis.
Non-surgical Treatment of Shoulder Impingement
Avoiding overhead activities, taking anti-inflammatory medication and stretching, as well as cortisone and local anesthetic injections, may relieve pain. In addition, your physician may recommend physical therapy.
Surgical Treatment of Shoulder Impingement
Arthroscopic surgery can remove the shoulder impingement and create more space for the rotator cuff through subacromial decompression or anterior acromioplasty. Both of these procedures are minimally invasive and promise reduced scarring, decreased pain and a significantly shorter recovery period.
Shoulder Impingement Rehabilitation
After surgery the patient may be placed in a sling for a short time to allow for healing. Then physical therapy will begin to increase range of motion and strength. Recovery may take only two to four months at minimum, but can be as long as one year.
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