Shoulder Impingement

Shoulder impingement syndrome can be a source of persistent discomfort and limitation for many individuals, affecting their ability to perform everyday tasks and participate in activities they enjoy. This article will delve into the ins and outs of shoulder impingement syndrome, exploring its causes, symptoms, diagnosis, and treatment options. 

If you’re experiencing shoulder pain or stiffness that interferes with your quality of life, take the first step towards relief by scheduling an appointment with Orthopedic Specialists & Sports Medicine, serving Granville and Coshocton, Ohio. Contact us today!

What is Shoulder Impingement Syndrome?

Shoulder impingement syndrome happens when the rotator cuff tendons in your shoulder get pinched or irritated. Your rotator cuff is a group of muscles and tendons that keep your shoulder joint stable. When you do activities like lifting your arm, the space between your upper arm bone and shoulder blade gets smaller, sometimes squeezing the soft tissues.

It can feel like a dull ache deep in your shoulder joint, especially when you raise your arm. You might also notice shoulder pain when reaching behind your back or lifting things overhead. Sometimes, it feels like your shoulder is weak or stiff.

What Are the Different Types of Shoulder Impingement?

Shoulder impingement syndrome comes in two main types: internal impingement and external impingement.

  1. Internal Impingement: This happens when the rotator cuff muscles and the biceps tendon get pinched between the upper arm bone and the shoulder blade. It often occurs in athletes who do a lot of overhead arm movements, like baseball pitchers or swimmers. Internal impingement usually affects the back of the shoulder joint.
  2. External Impingement: External impingement occurs when the space between the acromion (a part of the shoulder blade) and the rotator cuff tendons narrows. This compression can lead to irritation or injury of the rotator cuff tendons. External impingement typically affects the front of the shoulder joint and is more common in people who engage in repetitive overhead activities, like painters or weightlifters.
A tennis player with shoulder impingement.

What Causes Shoulder Impingement?

Shoulder impingement syndrome is often caused by activities that involve repetitive overhead arm movements, like painting, swimming, or playing tennis. 

These actions can lead to the narrowing of the space between the top of the upper arm bone (humerus) and a part of the shoulder blade called the acromion, where the rotator cuff muscles and tendons pass through.

When this space becomes too tight, it can pinch or irritate the rotator cuff tendons and the bursa (a fluid-filled sac that helps reduce friction between tissues in the shoulder joint). Over time, this irritation can lead to inflammation, swelling, and even small tears in the rotator cuff tendons, causing shoulder impingement syndrome.

Other factors that can contribute to shoulder impingement syndrome include:

  1. Anatomical Variations: Some people naturally have a shape of the acromion that predisposes them to impingement. For example, a hooked or curved acromion can reduce the space available for the rotator cuff tendons.
  2. Muscle Weakness or Imbalance: Weakness or imbalance in the muscles around the shoulder joint, particularly the rotator cuff muscles, can alter the mechanics of the shoulder and contribute to impingement.
  3. Poor Posture: Slouching or rounded shoulders can affect the alignment of the shoulder joint, increasing the risk of impingement.
  4. Trauma or Injury: Direct trauma to the shoulder or repetitive microtrauma from activities can also contribute to the development of shoulder impingement syndrome.

Shoulder Impingement Symptoms

Shoulder impingement syndrome can cause several common symptoms that can affect your daily activities and quality of life:

  1. Shoulder Pain: Pain is the most common symptom of shoulder impingement syndrome. It often feels like a dull ache deep within the shoulder joint. The pain may worsen when you lift your arm, reach overhead, or perform activities that involve using your shoulder.
  2. Weakness: You may experience weakness in your shoulder, making it difficult to lift objects or perform tasks that require arm movement. This weakness can affect your ability to participate in sports or carry out routine activities.
  3. Limited Range of Motion: Shoulder impingement can lead to a decreased range of motion in your shoulder joint. You may find it challenging to raise your arm fully or reach behind your back. This limitation can interfere with everyday tasks like getting dressed or reaching for items on high shelves.
  4. Stiffness: Your shoulder may feel stiff, especially in the morning or after prolonged periods of inactivity. Stiffness can make it uncomfortable to move your shoulder and may worsen the pain associated with impingement.
  5. Pain at Night: Shoulder impingement syndrome can cause discomfort while lying on the affected shoulder, making it difficult to find a comfortable sleeping position. This can result in disrupted sleep and fatigue during the day.
  6. Clicking or Catching Sensation: Some people with shoulder impingement may experience a clicking or catching sensation when moving their shoulder. This can occur due to the irritation or impingement of the tendons as they move within the shoulder joint.
 

If you’re experiencing any of these symptoms, it’s essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment to relieve pain and restore function to your shoulder.

How is Shoulder Impingement Syndrome Diagnosed?

To diagnose shoulder impingement syndrome, a healthcare provider will typically start by conducting a thorough physical examination. During this exam, they’ll assess your shoulder’s range of motion, strength, and tenderness. They may also perform specific tests, like the Neer and Hawkins tests, which involve moving your arm in certain ways to reproduce symptoms.

Imaging tests, such as X-rays or magnetic resonance imaging (MRI), may be ordered to visualize the structures inside your shoulder joint and rule out other possible causes of your symptoms, like a bone spur or a rotator cuff tear.

Based on the findings from the physical examination and imaging studies, your healthcare provider can diagnose shoulder impingement syndrome and develop a treatment plan tailored to your needs. It’s crucial to consult a healthcare professional to accurately diagnose shoulder impingement and receive appropriate care.

How is Shoulder Impingement Syndrome Treated?

Treatment for shoulder impingement syndrome aims to relieve pain, reduce inflammation, and improve shoulder function. Here are common approaches:

  1. Rest and Activity Modification: Resting the shoulder and avoiding activities that worsen symptoms can help reduce inflammation and allow the shoulder to heal. Modifying activities to avoid overhead movements can also prevent further irritation.
  2. Ice and Medications: Applying ice packs to the shoulder can help reduce pain and inflammation. Over-the-counter anti-inflammatory medications like ibuprofen or naproxen may also be recommended to manage pain and swelling.
  3. Physical Therapy: A physical therapist can design a personalized exercise program to strengthen the muscles surrounding the shoulder joint, including the rotator cuff muscles. These physical therapy exercises help improve shoulder stability and mobility, reducing the risk of impingement.
  4. Corticosteroid Injections: In some cases, corticosteroid injections may be administered directly into the shoulder joint to reduce inflammation and provide pain relief. These injections are often used in combination with other treatments.
  5. Shoulder Impingement Surgery: If conservative treatments fail to provide relief, surgery may be considered. Shoulder impingement surgery aims to create more space within the shoulder joint by removing bone spurs or other structures that may be causing impingement. Arthroscopic surgery, which involves small incisions and a camera to guide the procedure, is commonly performed for shoulder impingement.
  6. Post-Surgery Rehabilitation: Following surgery, a period of rehabilitation is crucial to regain strength and mobility in the shoulder. Physical therapy exercises and the gradual reintroduction of activities help ensure a successful recovery.
 

It’s essential to consult with a healthcare professional to determine the most appropriate treatment plan based on the severity of your symptoms and individual needs. Early intervention and consistent management are key to effectively managing shoulder impingement syndrome and preventing long-term complications.

Taking Control of Shoulder Impingement

Shoulder impingement syndrome can cause significant discomfort and limitations in daily activities, but with the right approach, relief is within reach. 

If you’re experiencing persistent shoulder pain or difficulty with arm movements, don’t hesitate to seek help from a qualified orthopedic specialist. At Orthopedic Specialists & Sports Medicine, with locations in Granville and Coshocton, Ohio, our team of experts is dedicated to providing comprehensive care for shoulder impingement and other orthopedic conditions.

Take the first step towards a pain-free shoulder by scheduling an appointment today. Your journey to better shoulder health starts here.

Medically reviewed by Brad L. Bernacki, MD