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Shoulder Impingement

What is Impingement Syndrome?


Impingement syndrome is a common overuse injury seen in athletes who participate in sports that require repetitive overhead activities or people who work with their arms overhead. 


Impingement syndrome is inflammation of the rotator cuff tendon as it runs underneath the acromion process.  When you lift your arm, the inflamed tendon becomes pinched between the acromion process and the head of the humerus, causing pain with any movements in which the arm is raised, usually above shoulder level.


What causes impingement syndrome?


Initially, inflammation of the rotator cuff or subacromial bursa due to repetitive motion or overuse or degeneration of the tendon over time can cause impingement syndrome.  Repetitive damage may weaken the rotator cuff and further progress the impingement as the rotator cuff will not function normally.  Normally, the rotator cuff maintains the head of the humerus within the glenoid as the arm moves outward.  With weakening, the humerus will slide up further then it should, worsening the impingement syndrome.

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How can I prevent impingement syndrome?


Tightness and weakness of the rotator cuff muscles combined with overusing the shoulder are the common causes of impingement syndrome.  Prevention focuses of stretching and strengthening all of the rotator and shoulder blade muscles.  While a rehabilitation program can help protect the rotator cuff, you must take care not to overuse the shoulder with sporting or other activities.  If you have pain during or after an activity, then you should modify or stop that activity to protect your shoulder.


How do you treat impingement syndrome?


Treatment of impingement syndrome should begin with resting the shoulder and modifying your activity.  Anti-inflammatory medication and physical therapy can be used to decrease pain and restore normal mechanics.  It is important not to continue your regimen in pain, as the injury will not heal and may become a chronic problem.  Cortisone injections may be used as well if no improvement is seen with other conservative treatments.  Ultimately, if there is structural damage, like a partial-thickness rotator cuff tear, or you fail conservative treatment, then a shoulder arthroscopic surgical intervention is indicated to remove inflammatory tissue and offending bone spurs.

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