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Guide to Shoulder impingement

What is a shoulder impingement?

What is shoulder impingement?

Shoulder impingement is a common cause of shoulder pain. It happens as a result of impingement of tendons specifically of the supraspinatus muscle and the bones from the shoulder. Repeated impingement causes irritation of the tendon which can lead to inflammation and pain due to narrowing of the gap that is created as a result of overhead shoulder movements.

The onset of shoulder impingement is usually related to its overuse. Initially, the symptoms may be limited to sharp pain when performing overhead activities. As the condition progresses the patient may develop a constant ache that is present at night. Some of the other symptoms that may be experienced are:

  • Local tenderness over the shoulder
  • Painful arm movements during side lifting and forward lifting
  • Pain that gets worse while sleeping on that side

What causes a shoulder impingement?

Shoulder impingement occurs as a result of a self-perpetuating cycle of dysfunction. Repetitive insult to the tendon leads to wear and tear which causes weakening of the tendon and reduces its ability to oppose the shearing forces that are produced with overhead movements of the shoulder.

It is through this process the tendon becomes impinged and creates further insult. Those who do repetitive lifting or overhead activities using the arm such as painters, carpenters and weightlifters are more susceptible.

How is a shoulder impingement diagnosed?

The diagnosis of shoulder impingement will be based on the presenting symptoms and the completion of a complete physical examination which will include, orthopaedic, neurological and range of motion assessments which will determine the severity of the rotator cuff injury and any problems it may be causing to the rest of the body.

Our practitioners will try and eliminate other possible diagnoses that may have similar presentations so that a correct diagnosis can be reached. They may suggest ultrasound scans that would identify any tendinopathies that may have developed and will better help you in your treatments.

How is a shoulder impingement treated?

The goal of treatment is to reduce pain and restore function. In most cases, the treatment is non-surgical with many patients experiencing gradual improvement over time. The treatments will include stretching, strengthening exercises, myofascial therapy and treatments that will aim to restore your shoulder movements.

If with the help of physical therapy there is no improvement your practitioner may refer you to get an injection that is done in house with our specialist sports doctor. The injection is a very effective anti-inflammatory.

References

Alqunaee M, Galvin R, Fahey T. Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis. Archives of physical medicine and rehabilitation. 2012 Feb 1;93(2):229-36.

Yu H, Côté P, Shearer HM, Wong JJ, Sutton DA, Randhawa KA, Varatharajan S, Southerst D, Mior SA, Ameis A, Stupar M. Effectiveness of passive physical modalities for shoulder pain: systematic review by the Ontario protocol for traffic injury management collaboration. Physical therapy. 2015 Mar 1;95(3):306-18.

Kibler WB. Rehabilitation of rotator cuff tendinopathy. Clinics in sports medicine. 2003 Oct 1;22(4):837-47

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