Shoulder Impingement

SI 11 300x225 Shoulder ImpingementShoulder impingement syndrome is a common cause of shoulder pain. It occurs when there is impingement of tendons or bursa in the shoulder from bones of the shoulder. Overhead activity of the shoulder, especially repeated activity, is a risk factor for shoulder impingement syndrome. Examples include: painting, lifting, swimming, tennis, and other overhead sports. Other risk factors include bone and joint abnormalities. With impingement syndrome, pain is persistent and affects everyday activities. Motions such as reaching up behind the back or reaching up overhead to put on a coat or blouse, for example, may cause pain.

Causes of Shoulder Impingement

Any process which compromises this normal gliding function may lead to mechanical impingement. Common causes include weakening and degeneration within the tendon due to aging,the formation of bone spurs and/or inflammatory tissue within the spaceabove the rotator cuff (subacromial space) and overuse injuries. Overuse activities that can lead to impingement are most commonly seen in tennis players, pitchers and swimmers


The first step in treating shoulder impingement is eliminating any identifiable cause or contributing factor. This may mean temporarily avoiding activities like tennis, pitching or swimming. A nonsteroidal anti-inflammatory medication may also be recommended by your doctor. The mainstay of treatment involves exercises to restore normal flexibility and strength to the shoulder girdle, including strengthening both the rotator cuff muscles and the muscles responsible for normal movement of the shoulder blade. This program of instruction and exercise demonstration may be initiated and carried out either by the doctor, certified athletic trainer or a skilled physicaltherapist. Occasionally, an injection of cortisone may be helpful in treating this condition.

Is Surgery Necessary?

Surgery is not necessary in most cases of shoulder impingement. But if symtoms persist despite adequate nonsurgical treatment, surgical intervention may be beneficial. Surgery involves deriding, or surgically removing, tissue that is irritating the rotator cuff. This may be done with either open or arthroscopic techniques. Outcome is favorable in about 90 percent of the cases.

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