What is Shoulder impingement?

Shoulder impingement, also known as subacromial impingement syndrome, is a common condition characterized by compression or pinching of the soft tissues (tendons, bursa) within the shoulder joint as they pass through the subacromial space. This impingement can lead to pain, inflammation, and limited range of motion in the shoulder.

How does Shoulder impingement happen?

Shoulder impingement occurs when the space between the acromion (bony projection of the scapula) and the humeral head (upper arm bone) narrows, causing the structures within the shoulder joint, such as the rotator cuff tendons and subacromial bursa, to become compressed or irritated. This narrowing of the subacromial space can result from various factors, including repetitive overhead movements, poor posture, muscle imbalances, or structural abnormalities in the shoulder joint.

Why is my Shoulder impinged?

Several factors can contribute to shoulder impingement, including:

• Overuse or repetitive stress on the shoulder joint, is commonly seen in athletes, manual labourers, or individuals engaged in activities that involve repetitive overhead motions.
• Muscle weakness or imbalances, particularly in the muscles surrounding the shoulder blade (scapula) and rotator cuff.
• Poor posture, such as rounded shoulders or forward head posture, which can alter the biomechanics of the shoulder joint and increase the risk of impingement.
• Anatomical variations or structural abnormalities in the shoulder joint, such as bone spurs, acromial shape abnormalities, or variations in the shape of the acromion process.

What are the symptoms?

Common symptoms of shoulder impingement may include:

• Pain or tenderness in the front or side of the shoulder, particularly with overhead movements or reaching behind the back.
• Pain that worsens at night, especially when lying on the affected shoulder.
• Weakness or stiffness in the shoulder joint, makes it difficult to perform activities such as lifting, reaching, or carrying objects.
• Clicking or popping sensations in the shoulder during movement.
• Gradual onset of symptoms, often worsening over time with repetitive use or strain on the shoulder.

How is Shoulder impingement diagnosed?

Shoulder impingement is typically diagnosed through a combination of medical history, physical examination, and imaging studies. Common methods of diagnosis may include:

• Assessment of symptoms, such as pain, tenderness, and limited range of motion in the shoulder joint.
• Physical examination, including tests to evaluate strength, flexibility, and stability of the shoulder.
• Imaging studies, such as X-rays, MRI scans, or ultrasound, to visualize the structures within the shoulder joint and assess for signs of impingement, inflammation, or structural abnormalities.

What are the treatment options?

Treatment options for shoulder impingement may include:

• Rest and activity modification: Avoiding activities that exacerbate symptoms and giving the shoulder time to heal.
• Ice therapy: Applying ice packs to the shoulder to reduce pain and inflammation.
• Pain management: Over-the-counter or prescription medications, such as NSAIDs or corticosteroid injections, to alleviate pain and swelling.
• Physical therapy: Rehabilitation exercises to strengthen the muscles surrounding the shoulder, improve flexibility, and correct biomechanical imbalances.
• Modification of activities: Avoid repetitive overhead motions or activities that aggravate symptoms.
• Surgical intervention, such as arthroscopic subacromial decompression, may be considered if conservative treatments fail to provide relief or in cases of severe impingement or structural abnormalities.

What does the recovery process involve?

Recovery from shoulder impingement surgery varies depending on factors such as the extent of the procedure, individual healing factors, and adherence to postoperative rehabilitation protocols. Generally, recovery may involve:

• Immobilisation of the shoulder with a sling or brace immediately following surgery to protect the joint and promote healing.
• Physical therapy or rehabilitation exercises to restore strength, flexibility, and range of motion of the shoulder joint.
• Gradual return to activities and sports, following the guidance of healthcare providers and rehabilitation specialists.
• Full recovery may take several weeks to months, with some individuals requiring ongoing management to prevent recurrent symptoms or complications.