Shoulder Impingement Syndrome
Left untreated, impingement can lead to a rotator cuff tear.
The rotator cuff tendons inside the shoulder rub against the acromion bone above, causing inflammation. The bursa swells and the acromion can form a spur pointing downward.
Common causes
01
Constant heavy use of the shoulder
02
Enjoying intense sports
03
Working with poor posture
It is common in jobs that keep the arms raised and in sports that use the shoulder a lot, and in people who keep using the shoulder without rest. Primary causes include age-related degeneration of the cuff, poor blood supply and impingement under the acromion. Secondary causes include overuse, poor posture, falls onto an outstretched arm, inflammatory conditions and direct trauma.
Signs to watch for
- Pain at the front or side of the shoulder when raising the arm
- Clicking or grinding in the shoulder
- Unable to lie on the painful side
How we diagnose
X-ray
The basic first test. Further tests may be added for a definite diagnosis.
Ultrasound
Examines the joint while it moves, so problems that appear only in certain positions can be found. Inflamed areas can be treated with guided injections at the same time.
How we treat it
Treat it as soon as you notice symptoms. If the rotator cuff still works normally, non-surgical treatment can reduce pain.
Extracorporeal shockwave therapy
Used across orthopedics, physical therapy and sports medicine, shockwave therapy aids recovery without surgery or painkillers and suits many conditions that cause acute or chronic pain.
Manual & exercise therapy
A specialist physical therapist uses hands-on techniques based on anatomy, such as relaxation methods and joint mobilization, to reduce pain and improve function.
Arthroscopy
Through a minimal incision under about 5 mm, an arthroscope with a tiny camera and special instruments is inserted into the joint. It shows areas that are hard to see on X-ray, allowing accurate diagnosis and treatment at the same time.
When surgery is consideredSurgery is considered if there is no improvement or the rotator cuff is fully torn. Most operations can now be done arthroscopically.