What is Shoulder Impingement?
Shoulder impingement occurs when there is pain or irritation to the rotator cuff muscle/tendon due to the acromion applying too much downward pressure, or impinging the rotator cuff structures. The rotator cuff is a group of muscles that attach to the humerus and passes beneath the acromion, so if there is inflammation to that space, then impingement syndrome could affect your ability to complete overhead activities due to pain.
Shoulder Impingement Symptoms
Symptoms for shoulder impingement may include:
- Overall pain in the front part of your shoulder
- Pain with shoulder movement when extending overhead (reaching) and lowering the arm from a raised position
- Pain in the shoulder while reaching behind your back (as if to tuck in your shirt)
- Shoulder/arm weakness and stiffness
- Shoulder/arm aching and tenderness sensation
- Pain when laying side lying on affected side
Causes of Shoulder Impingement
The lack of space below the acromion impedes the manner in which the shoulder and structures involved would typically glide with movement.
General causes of shoulder impingement can be related to over-use with overhead activities, age related wear and tear, inflammation or irritation to the tendon or bursa below the acromion, and shape of the acromion to include bony spurs. The inflammation ultimately decreases the space that allows the rotator cuff and other structures below to pass through in a more rigid manner causing the pain and discomfort in the shoulder.
Shoulder Impingement Conservative Treatments
Conservative treatment is aimed at decreasing pain in the affected shoulder and increasing functional movement of the shoulder. RICE-rest, ice, compress, elevate should be implemented while the affected shoulder is recovering to include anti-inflammatory medications, shoulder and arm stretches/exercises from your OT, and short-term avoidance of movements that irritate the shoulder in your everyday life (activity modifications).
What Does Shoulder Impingement Surgery Look Like?
Should conservative treatment prove unsuccessful then cortisol injections may assist with pain management. Surgery for shoulder impingement may include but is not limited to subacromial decompression which removes a part of the acromion to increase space for the rotator cuff to pass (typically arthroscopically), or open surgery which entails creating a larger cut to the front of the shoulder.
Precautions/Contraindications?
It is beneficial to avoid activities and motions which aggravate the affected shoulder. Do not continue to use the arm/shoulder in tasks which reproduce the pain and discomfort and seek medical advice should symptoms persist or worsen with time. Ask your physician if you have any questions or concerns.
References
https://my.clevelandclinic.org/health/diseases/7079-shoulder-impingement-syndrome
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