Shoulder Impingement


What is shoulder impingement? 

Shoulder impingement syndrome is a common cause of shoulder pain, and occurs when your shoulder's rotator cuff tendons and/or bursa are intermittently trapped and compressed during shoulder elevation movements. Over time, impingement can lead to inflammation of the rotator cuff tendons (tendinitis) and bursa (bursitis). If not treated appropriately, the rotator cuff tendons can start to wear thin, leading to a rotator cuff tear. With impingement syndrome, pain is persistent and affects everyday activities.


What causes shoulder impingement?

Impingement results from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted. The most common cause of shoulder impingement is overuse, but age is also a factor. Over time, any activity with repetitive overhead movements may increase the risk of impingement. The longer a person has spent doing these types of activities, the more likely the symptoms become. Injuries, such as a dislocated shoulder, are also another cause of shoulder impingement. If tendons are injured for a long period of time, the tendon can actually tear, resulting in a rotator cuff tear.


What are the symptoms?

The classic symptoms of shoulder impingement are difficulty lifting the arm past shoulder height and reaching the arm behind the back. Other common symptoms include:

  • Weakness of the arm and shoulder
  • General stiffness and throbbing in the shoulder
  • Shoulder aching when at rest and increased pain with activity
  • Exacerbated pain with lying on the affected side
  • Pain or clicking when putting your hand behind your back or head
  • Without treatment, the tendons in the rotator cuff may wear down or tear, which can lead to worse pain, shoulder weakness, and difficulty lifting or using the shoulder at all


How is shoulder impingement treated? 

There are numerous structures within the shoulder that can be injured with shoulder impingement, and each structure may require a different treatment modality. Understanding the reason your impingement occurred in the first place is actually the most important step in determining the course of treatment, especially when it comes to preventing potential rotator cuff tears and surgery to repair them. 

The initial treatment of shoulder impingement centers around conservative treatment options. These include rest, activity modification, anti-inflammatory medications, physical therapy, and steroid injections. In cases where the body does not respond to non-operative management, Dr. Potts may recommend minimally invasive shoulder impingement surgery to widen the space around the rotator cuff and prevent friction. This will allows easier movement without catching or rubbing on your bone. In cases with concurrent rotator cuff tears, a surgical rotator cuff repair may also be necessary.