Shoulder Impingement Syndrome is one of the most common causes of shoulder pain. This condition takes place due to an impingement in bursa orshoulder impingement tendons present in the shoulder. People that have repetitive, strenuous movements, or frequently use their arms above their head are at a higher risk of this condition. The examples include swimming, painting, and tennis along with other varied overhead sports. Joint abnormalities are one among other risk factors.

A Shoulder impingement may occur alone, or in combination with shoulder bursitis and or rotator cuff tendinitis. The impingement starts with an injury to the rotator cuff muscles, which respond by swelling. This swelling causes the pressure within the muscles to increase resulting in compression and loss of blood flow. The limited blood flow in turn affects the muscles.

Symptoms

Many patients suffering from an impingement in the shoulder report the following symptoms:

  • A sharp shoulder pain is felt when raising the arm to shoulder height or higher.
  • Shoulder pain which can extend from the top of the shoulder to the elbow.
  • Experiences pain when you lie on the side of the suspected shoulder.
  • Experiencing muscle pain or weakness while attempting to lift or reach.
  • Pain while the hand is being put behind the head or back.
  • Pain when reaching for seat belt.

If you experience any of the above symptoms, or something similar, it is best to describe these to your doctor. This will greatly aid them in being able to diagnose your injury.

Explanation

Shoulder Impingement Syndrome is a condition in which the tendons of the shoulders intermittently get trapped, while being compressed at the time of shoulder movements. As a result, shoulder tendons get injured along with bursa. This further results in extremely painful movements in the shoulders. When the condition takes place, the rotator cuff gets swollen and inflamed. Likewise, when bursa gets inflamed, the shoulder bursitis can develop. Both of these conditions has the power to co-exist while being present in an independent manner.

The most common way to injure the shoulder is through overuse of overhead movements. This can cause the rotator cuff to come in contact with the shoulder blade’s outer end. When this takes place in a repeated manner, the rotator cuff gets trapped, while being pinched under the acromion. The injuries which take place range from mild inflammation of the tendon, to bursitis and calcific tendonitis.
Rotator cuff strain

Treatment

The most common types of treatment involve the use of anti-inflammatory drugs such as ibuprofen, aspirin and others. These medications are taken for about 10-14 days, and if by then the symptoms are still there, they are changed. To have effective treatment, the medications have to be taken for a long periods up to around eight weeks. In addition to the medication, shoulder exercises have to be done at home.

Caution should be taken not to do repetitive exercises, or tasks that involve raising the arm overhead. Impingement physical therapy is another way of dealing with the injury. This is done under the supervision of a physical therapist whereby the initial focus is restoring motion. During your impingement physical therapy, you will also do stretching exercises of the posterior capsule, which is very effective in relieving pain and helps to increase the range of motions of the injured arm. Tightness of the posterior capsule is what makes it difficult to reach your arm at the back. If medication and impingement physical therapy does not work steroids, injection is used whereby the doctor injects a local anesthesia and cortisone preparation.

Corticosteroid injections

These injections are an extremely useful treatment, but only should be used if the pain is severe. In case the conservative methods do not reduce pain, then this can be a great way to reduce pain and swelling. Once the pain is gone, it is crucial to assess the strength, involvement of the neck and spine, and flexibility. You also need to ensure that the impingement does not return once the injection wears out.

Common treatment:

  • Treatment of early injury
  • Rotator Cuff Exercises
  • Dry needling and acupuncture
  • Biomedical analysis
  • Stabilization exercises  for the Scapula

Exercises for a Shoulder Impingement

Stretching and mobility

Stretches should be performed regularly while continued through entire process of rehabilitation. Following are few important stretches which need to be performed for encouraging improved posture.

Chest stretch

Place the forearm in a particular fixed point like a doorframe or the wall’s corner. Then you need to lean forward in a gentle manner while turning away for stretching chest muscles. Hold this particular position for a period of about 30 seconds while repeating it for 3 times. This makes the athlete feel a stretch in the anterior portion of the shoulder.

Supraspinatus stretch

Place your hand on your lower back, while using your other hand to pull the elbow in a forward motion. By keeping the hand on the lower back, you feel a deep stretch at the back of the shoulder. Hold on to this for about 30 seconds and then repeat for 5 times.

Strengthening exercises

This help in drifting the humeras head upward and forward as the muscles become weak. This exercise helps in strengthening the rotator-cuff along with the scapular muscles. This help in positioning the humeras head while easing out the impingement. You also can perform exercises of resistance training in order to strengthen the weaker muscles.

Retraction

Keep the arm straight along with the head. It is only the shoulder that needs to move. Perform 3 sets of 10 repetitions.

Scapula Squeeze

These exercises are designed to help you gain control over your shoulder blades. This is done by squeezing back and then holding them again.

Read about more shoulder impingement exercises.

Surgery

Arthroscopy involves the insertion of a thin device with a small lens, in a tiny incision, in order to look inside the shoulder joint. The images reflected on the monitor allow the doctor to diagnose the patient. It can be performed on the basis of an outpatient. Other kind of surgical instruments are inserted in order to make repairs, but are usually based on the kind of arthroscopy it is. Other surgery options can also be considered. 

Recovery From Surgery

After the shoulder impingement surgery, the patient will need to wear an arm sling for a few weeks. Some patients are prescribed anti-inflammatory medications. A post-operative physiotherapy is needed so the arm can regain its strength and flexibility. Some patients may feel pain in the treated shoulder after the recovery time has passed. This could result in another surgery being needed, although this is a rare case. After the period of reduction of activity is successfully completed, the patients who had the procedure are recommended to practice yoga, t’ai chi ch’uan or another discipline that is not aggressive, but activates all parts of the body, in order to maintain the proper function and flexibility.