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Shoulder Impingement

pain in shoulder

This common shoulder pain can make simple motions, such as reaching overhead, very difficult.

What is Shoulder Impingement Syndrome?

Shoulder impingement syndrome occurs when tendons of the rotary cuff become irritated and inflamed (impinged) as they pass through the shoulder joint. Also known as “swimmer’s shoulder,” “thrower’s shoulder,” and “subacromial impingement,” shoulder impingement syndrome is a common cause of shoulder pain which affects everyday life, making simple motions such as reaching overhead or behind the back difficult. If shoulder impingement persists, it can lead to rotary cuff tendinitis, inflammation of the bursa (which lines the tendons), or a rotary cuff tear.

Shoulder Joint Anatomy

The shoulder joint can be likened to a ball and socket, where the top of the arm bone forms a joint with the shoulder blade. What holds the arm bone and shoulder blade together and controls the movement of the shoulder joint is the rotator cuff. In turn, the tendons of the rotator cuff pass through a narrow “subacromial space.” When they get irritated and inflamed (impinged), or in the case of a bone spur, this space becomes even more narrow, causing pain and reducing the mobility of the shoulder joint and muscles.

Shoulder Impingement Risk Factors

Risk factors for developing shoulder impingement syndrome include:

  • Repeated use/overuse of the shoulder muscles (i.e. baseball pitchers, tennis players, swimmers, painters, carpenters, and people who lift heavy objects overhead)
  • Joint and bone abnormalities
  • Sleeping on the same arm every night
  • Holding the arm in one position for extended periods of time (i.e. hairdressers, computer workers)
  • Aging
  • Poor posture over time

Shoulder Impingement Symptoms

Impingement syndrome is associated with pain which may be mild at first, occurring only when performing certain arm movements. Over time, pain becomes persistent and is especially prominent at night and when lying on the affected shoulder. Additional symptoms include:

  • Shoulder pain, especially with overhead motions
  • Shoulder weakness
  • Shoulder stiffness
  • Trouble holding the arm out to the side
  • Difficulty reaching behind the back
  • Bicep muscle rupture (if impingement process continues over time)

Shoulder Impingement Syndrome Treatment

Note the recovery from impingement syndrome can take weeks to months. Treatment for shoulder impingement involves the following:

  • Resting the shoulder from any painful movements/activities
  • Applying ice (cold packs) to reduce pain and inflammation
  • Taking anti-inflammatory medications to reduce swelling and pain
  • Physiotherapy (learning exercises which strengthen and stretch the rotator cuff muscles)
  • Cortisone injection if symptoms persist
  • In severe cases, surgery to repair a torn rotator cuff or remove a bone spur

How to Prevent Shoulder Impingement Syndrome

Exercises which strengthen and restore mobility to the shoulder joint play an important role in preventing the condition from reoccurring. Stretching exercises and massages are also recommended, helping to relax tight rotator cuff and upper back muscles.

Since poor posture over time can give rise to shoulder impingement, it is also important to correct postural problems and strengthen the muscles in the chest, upper, and lower back.