Shoulder Impingement

Shoulder impingement, also known as subacromial impingement, is a medical condition that occurs when the tendons of the shoulder joint are compressed or pinched by the surrounding bones and soft tissues.

Causes and Risk Factors

• Repetitive overhead movements or activities, such as throwing, lifting, or swimming
• Poor posture or muscle imbalances in the shoulder and upper back
• Weakened or torn rotator cuff muscles or tendons
• Bony growths or spurs on the acromion (the bony projection above the shoulder joint)
• Shoulder instability or previous injuries to the shoulder joint

Symptoms

• Pain or tenderness in the shoulder, especially when lifting or reaching overhead
• Weakness or fatigue in the shoulder muscles
• Limited range of motion or stiffness in the shoulder joint
• Snap or click sensation when moving the shoulder
• Pain that worsens at night, especially when sleeping on the affected side

Diagnosis

Diagnosis of shoulder impingement typically involves a combination of:

• Medical history and physical examination to assess symptoms and range of motion
• X-rays or other imaging tests (such as MRI or CT scans) to evaluate the bones and soft tissues of the shoulder joint
• Specialized tests, such as the Neer test or Hawkins-Kennedy test, to assess for impingement

Treatment Options

Treatment for shoulder impingement typically involves a combination of:

• Conservative management, including rest, ice, compression, and elevation (RICE) to reduce pain and inflammation
• Physical therapy to improve range of motion, strength, and flexibility in the shoulder joint
• Pain relief medications, such as NSAIDs or corticosteroid injections, to manage symptoms
• Surgical intervention, such as arthroscopy or open surgery, to repair or remove damaged tissues and bony growths

Prevention and Management

To prevent or manage shoulder impingement, individuals can:

• Maintain good posture and muscle balance in the shoulder and upper back
• Avoid repetitive overhead movements or activities that aggravate symptoms
• Strengthen the rotator cuff muscles through exercises and physical therapy
• Use proper lifting techniques to avoid putting excessive strain on the shoulder joint

Complications and Prognosis

If left untreated or poorly managed, shoulder impingement can lead to:

• Chronic pain and limited mobility in the shoulder joint
• Tendinosis or tears in the rotator cuff muscles or tendons
• Bony growths or spurs that can further compress the tendons and soft tissues
• Reduced quality of life and functional ability due to persistent symptoms and limited mobility