CNY Orthopedic Sports Medicine, PC: Injury: Shoulder Impingement

Injuries and Conditions: Shoulder: Shoulder Impingement

Overview
Impingement syndrome refers to the mechanical compression and/or wear of the rotator cuff tendons as they pass under the bony structure of the shoulder. This compression can cause inflamation of the subacrominal bursa and other structures of the joint, resulting in a persistent increase in pain, tenderness, and loss of motion in the affected shoulder. Normally the rotator cuff glides smoothly and without irritation between the undersurface of the acromion and the humeral head. A healthy rotator cuff is essential to shoulder strength, flexibility, and control. One potential outcome of impingement syndrome is a rotator cuff tear.

The rotator "cuff" is actually a collective or a cohesion of a group of four musculoskeletal structures that share a common tendon. The muscles originate at different places on the shoulder blade and insert on the upper portion of arm bone. This group of muscles attach on or near the humeral head humerus, via a combined tendon.

  • Common rotator cuff injuries include, in addition to impingement, tendonitis, bursitis, and tears of the rotator cuff.
  • Impingement is more common in older adults, ages 50+.
  • Activities frequently associated with this injury include, tennis, swimming, baseball, and football.
  • Non-surgical treatment is effective therapy for cuff injuries that do not involve a tear.
  • A full tear will require surgery as the torn or abraded tendons will not heal without surgical repair or augmentation.


  • Signs and Symptoms
  • Pain or weakness is present with overhead arm activities or when the arm is held abducted away from the body.
  • Muscles may "catch" or "grate" when your arm is rotated or raised.
  • Inability to sleep on the affected side due to pain.
  • With a complete or partial rotator cuff tear resulting from impingement, you may be unable to raise or extend the arm.

  •  
    Contact the Doctor if ...
  • The patient has the signs and symptoms indicating impingement syndrome.
  • Non-surgical therapy has failed to control the pain and restore shoulder function.
  • Unexpected side effects occur from over the counter or prescription medications.

  • Common Causes of Injury
  • Injury to the rotator cuff can result from encroachment of degenerative bone spurs on the the tissues surrounding the rotator cuff. Chronic wear and tear and/ or aging further contribute to the symptoms of impingement.
  • Activities which require repeated overhead arm movement may aggravate this condition. Examples of such activities include tennis, swimming, baseball, softball and football.


  • Expectations of Recovery
  • A successful recovery is dependent on the severity of the condition and level of physical therapy to rehabilitate the shoulder.
  • Through non-surgical treatment, symptoms may diminish in several weeks, but a return to full activity may take several months.
  • Factors effecting surgical recovery include your age, physical condition, and the presence or absence of a rotator cuff tear, and the size of the tear if one is present.

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