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The Truth About Shoulder Impingement

Occasionally, it’s important to ask ourselves, “How do I know what I know?” I knew shoulder impingement was a valid and useful diagnosis because it was taught to me by my professors in physical therapy school. And my professors knew it was a valid and useful diagnosis because someone taught it to them. And that goes back at least 50 years. It’s the same reason surgeons have been performing the subacromial decompression or personal trainers advise against upright rows.

Bloodletting and leech therapy were used for thousands of years before someone finally questioned their validity and usefulness. Certain clinicians have actually been pushing back against the diagnosis of shoulder impingement…

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Articles of Interest

Exercises for Shoulder Impingement, from a PT

These three moves can help improve shoulder pain in a few weeks.

How to Fix Shoulder Impingement: Exploring Treatment Options

When you raise your arm, the space between the cuff and the acromion decreases. As the space becomes smaller, the cuff presses against the acromion — and that’s what causes pain and irritation.

Impingement Syndrome of the Shoulder

Patients with shoulder impingement syndrome suffer from painful entrapment of soft tissue whenever they elevate the arm. The pathological mechanism is a structural narrowing in the subacromial space. A multiplicity of potential etiologies makes the diagnosis more difficult; it is established by the history and physical examination and can be confirmed with x-ray, ultrasonography, and magnetic resonance imaging.

Management of Shoulder Impingement Syndrome and Rotator Cuff Tears

Causes of impingement include acromioclavicular joint arthritis, calcified coracoacromial ligament, structural abnormalities of the acromion and weakness of the rotator cuff muscles. Conservative treatment (rest, ice packs, nonsteroidal anti-inflammatory drugs and physical therapy) is usually sufficient.

Shoulder impingement

Have you heard this term before and wondered what exactly it is that your shoulder is pinching? The more important question is to ask is why it is it getting pinched.

Shoulder Impingement Explained

Since we live in a world of technology, where we spend hours on computers or phones in a slumped forward position creating a concavity in the chest, we tend to be prone to creating more opportunities for the shoulder to become impinged and generate pain.

Shoulder Impingement – A Painful Shoulder Condition

Shoulder impingement syndrome can best be described as a recurring ache/pain on the outside upper part of your shoulder when you raise your arm to shoulder height.

Subacromial Impingement

The four muscles that raise and lower the arm (and their respective tendons) are collectively known as the rotator cuff . The rotator cuff lies under the roof of the shoulder (an extension of the shoulder blade known as the acromion ). The space between the acromion and the rotator cuff tendons is filled by the subacromial bursa.

The Painful Shoulder: Shoulder Impingement Syndrome

The concept of shoulder impingement syndrome is attributed to Charles Neer following his paper published in 1972. The term shoulder impingement itself however now belongs to a group of terms that essentially describes pain in the shoulder region as a result of mechanical ‘impingement’ of the rotator cuff as it passes under the coraco-acromial ligament. If left untreated rotator cuff impingement may proceed to partial or complete rotator cuff tendon rupture.

You Have Shoulder Impingement – So What The Heck Does That Mean?

Unfortunately, there are other parts of the shoulder blade the stick out and take up space around the ball and socket: the acromion at the top and coracoid process in the front. Plus, there is some important stuff that sits between the top and front of the humerus and these bony prominences: rotator cuff tendons, biceps tendon, and a bursa!

Resources

5 Tips for Preventing Shoulder Impingement

In addition to athletes, older people are also more prone to shoulder impingement problems, primarily as a result of age-related changes that cause the tendons and other tissues to become more vulnerable to tears, fraying, and inflammation. Although shoulder impingement is certainly treatable, it’s obviously better to avoid the problem altogether when you can. Fortunately, there are some pretty simple steps you can take to help your shoulders stay healthy and strong.

The Institute for Athletic Medicine

Surgery is not necessary in most cases of shoulder impingement. But if symptoms persist despite adequate nonsurgical treatment, surgical intervention may be beneficial. Surgery involves debriding, or surgically removing, tissue that is irritating the rotator cuff. This may be done with either open or arthroscopic techniques. Outcome is favorable in about 90 percent of the cases.

Radiopaedia

Shoulder impingement describes a group of conditions characterized by the entrapment of musculoskeletal soft tissue within the shoulder, which primarily results in pain. The catching of the affected structures may be structural and/or functional in etiology.

StatPearls

Shoulder impingement syndrome is a painful condition of the upper extremity resulting from a structural narrowing of the subacromial space. It is primarily diagnosed by history and physical examination. The mainstay of treatment involves identification early before the onset of degenerative changes, physical therapy exercises to strengthen the shoulder girdle, and pharmacologic interventions to decrease inflammation.

UpToDate

Shoulder impingement syndrome (SIS) is a condition that causes shoulder pain. To diagnose SIS, health care providers look for a specific set of shoulder symptoms and certain clinical findings, which together suggest that the patient has the condition. In SIS, a part of a person’s shoulder is compressed against another part, and this causes pain with some shoulder movements.