Topics > Shoulder > Shoulder Impingement
Shoulder Impingement
Impingement syndrome is when the rotator cuff tendons (supraspinatus,
infraspinatus, teres minor and subscapularis) become trapped in the shoulder
joint. Repeated impingement can lead to inflammation and thickening,
which in turn will result in more impingement and trapping of the inflamed
tendons. The original cause can be overuse or one traumatic incident
such as a fall. This is a common condition in swimmers and throwers as
well as racket players or any athlete who has to make repeated movements
with arms above shoulders.
Shoulder impingement syndrome can be divided
in two categories, bursitis and tendonitis, which can occur independently
or together.
- Bursitis
The bursa is the lubricating sac located above the rotator cuff. Inflammation
of the bursa results in mild to severe pain with limited movement.
The initial treatment for bursitis is rest. If necessary, icepacks
can also
be prescribed, as well as anti-inflammatory drugs, steroid injections
and ultrasound therapy. Some patients require temporary use of
a sling. After
inflammation subsides, the patient should do shoulder strengthening
exercises. If conservative treatment fails, surgery may be required.
- Tendonitis
Inflammation of the rotator cuff tendons specifically results in
tendonitis, in which the patient is unable to maintain specific
arm positions.
Acute tendonitis will go away on it own if the activity that
caused the insult
is discontinued. After the inflammation is gone the patient can
gradually resume the activity in which heat, stretching and ice
is added into
the routine. More severe cases may require anti-inflammatory
drugs or a cortisone
injection. Again, as with bursitis, surgery may be required but
only after all other causes have been ruled out.
Shoulder pain should not be
ignored. Working through the pain with activities, like tennis or
golf may worsen the
problem.
Instead,
shoulder pain should
be addressed with your physician, especially if pain worsens
with activity. However, the first method to treating a painful shoulder
should always
be rest first.
