Let's talk about Shoulder Impingement
Hey Dr. Sterett, What is shoulder impingement?#shoulderimpingement
The term "Impingement" refers to a mechanical compression and/or wear of the rotator cuff tendons. It's all in relation to the rotator cuff, which consists of four muscles which connects "the humeral head" (upper part of the shoulder joint) with the the scapula, otherwise known as the shoulder blade.
Ok, Why is the #rotatorcuff so darn important?
A couple of reasons:
- To maintain the humeral head within the glenoid (socket) during normal shoulder function and...
- Upholding shoulder strength during many activities, whether it be high-level athletics or merely reaching into the cupboard for some gourmet fancy pink himalayan salt.
Normally, the rotator cuff glides smoothly between the undersurface of the acromion, the bone at the point of the shoulder, and the humeral head.
Sounds a little scientific (which it is), but all this mumbo-jumbo basically means that these sections of the shoulder all contribute healthy, optimally-functioning shoulders.
Ok Doc, How does #shoulderimpingement occur?
Glad you asked. Any process which compromises this normal gliding function may lead to mechanical impingement.
Common causes include weakening and degeneration within the tendon due to aging, the formation of bone spurs and/or inflammatory tissue within the space above the rotator cuff (subacromial space), and overuse injuries.
Overuse activities that can lead to impingement are most commonly seen in athletes such tennis players, baseball players, and swimmers.
How is #shoulderimpingement diagnosed?
The diagnosis of shoulder impingement can be fairly easily achieved when evaluation of a combination of patient history and a thorough physical examination.
Impingement commonly causes general pain that is exacerbated by using the shoulder to execute an overhead-type activity. Another complaint we see with impingement is people waking in the middle of the night or having trouble sleeping as the result of shoulder pain.
Confirmation of the diagnosis can be ascertained by the physician by manipulation of the shoulder during examination. We also have x-rays, which can identify bone spurs or subacromial narrowing. MRI's are another tool we have to take a closer look at the rotator cuff to see if we are dealing with a more advanced injury or condition.
How is #shoulderimpingement treated?
Firstly, you can't do what you could normally do if you have shoulder impingement. Sounds obvious, but for athletes, this often means shutting down what you love to do most- activities such as pitching a baseball, swimming, or whacking a tennis ball in the tradition of Bjorn Borg (or Serena Williams, for you youngsters).
Next, your physician could recommend:
- An antiinflammatory and some specific exercises which are meant to re-build the flexibility and strenght of the rotator cuff muscles.
- Cortisone shots to help ease the pain of the condition
- An exercise program which will be monitored by an athletic trainer, a physical therapist, or your physician.
When do you need surgery for #shoulderimpingement
Surgery is not necessary in most cases of shoulder impingement. But if symptoms persist despite adequate nonsurgical treatment, surgical intervention may be beneficial.
Surgery for shoulder impingement involves debriding (surgically removing) the tissue which is causing the irritation of your rotator cuff. This may be done with either open or arthroscopic techniques. Outcome is favorable in about 90 percent of the cases.