Understanding & Treating Shoulder Impingement

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Understanding & Treating Shoulder Impingement

About 4.5 million patients seek medical care for shoulder pain annually in USA and nearly half of them suffer from rotator cuff injuries, according to American Academy of Orthopaedic Surgeons.

Your shoulder is the most flexible joint in your body. But its wide range of movement also means that it’s easy to injure your shoulder.

Impingement of the shoulder is the most common cause of shoulder pain. It occurs due to the impingement of tendons in the shoulder.

Repeated usage of the shoulder joint will increase the chances of one suffering from this problem. This is especially so for athletes involved in sports such as tennis, swimming.

Unlike other injuries, pain is extremely persistent in shoulder impingement and affects all of the daily activities involving swinging of arms, and make even simple tasks difficult to do.


Your shoulder is one of the largest and most complex joints in the body. It is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).

The shoulder joint is formed where the humerus fits into the scapula, like a ball and socket. Your arm is kept in your shoulder socket by your rotator cuff, which is s a collection of muscles and tendons that surround the shoulder, giving it support and allowing a wide range of motion. These muscles and tendons form a covering around the head of your upper arm bone and attach it to your shoulder blade.

There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm.


Shoulder impingement syndrome is caused by compression of the tendons of the rotator cuff between a part of the shoulder blade and the head of the humerus. This can become a chronic inflammatory condition that may lead to a weakening of the tendons of the rotator cuff.

Rotator cuff pain is common in both young athletes and middle-aged people. Young athletes who use their arms overhead for swimming, baseball, and tennis are particularly vulnerable.

Occupations that requires repeated overhead lifting or work at or above shoulder height are also at risk of rotator cuff impingement.

Pain may also develop as the result of a minor injury. Sometimes, it occurs with no apparent cause.


The usual symptoms associated with shoulder impingement include tenderness and swelling in the front of the shoulder. You may have pain and stiffness when you lift your arm. There may also be pain when the arm is lowered from an elevated position.

Other symptoms include pain at night, loss of strength and motion, difficulty in doing activities that place the arm behind the back, such as buttoning or zippering. Athletes in overhead sports may have pain when throwing or serving a tennis ball.

Over time, the shoulder muscles will weaken and it would become almost impossible to place the arm over your head. Prolonged impingement will lead to the tearing of the shoulder muscles, leading to a rotator cuff injury.


The initial stages of treatment is non-surgical. Oral medications such as aspirin and ibuprofen will be prescribed in an attempt to reduce pain and inflammation.

Physical therapy is the best treatment option for the shoulder impingement syndrome. A professional therapist can advise on a suitable rehabilitation and exercise program which one can do easily at home and helps to heal the pain within a short time.

Also, performing yoga helps a lot. These stretching and strengthening exercises help to regain the strength and mobility of the injured arm and shoulder.

Treatment for shoulder impingement is based around reducing pain and inflammation, increasing flexibility, and identifying and correcting the possible causes to ensure it does not reccur.

If this conservative rehabilitation therapy do not seem to have an effect, corticosteroid injections are injected into the subacromial space to reduce inflammation, although this is not usually an early option.

When nonsurgical treatment does not relieve pain, your doctor may recommend surgery.


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