Shoulder impingement

Overview

Shoulder impingement is a painful condition that causes pain around the rotator cuff, both at rest and when moving the arm, especially in overhead motions. It is often referred to as swimmer’s shoulder or thrower’s shoulder, as it is a common source of shoulder pain in swimmers and throwing athletes. It can also affect weightlifters, construction workers and others who perform repetitive, overhead activities.

Shoulder impingement can come on gradually as a result of overuse or it can develop from a rotator cuff tear. This condition is caused by the tendons of the rotator cuff becoming impinged, or pinched, through a narrow, bony space in the shoulder known as the subacromial space. 

Anatomy of the shoulder

The shoulder is composed of the following:

  • Clavicle (collarbone)
  • Scapula (shoulder blade)
  • Humerus (upper arm bone)
  • Rotator cuff (group of muscles and tendons that surround the shoulder joint, keeping the head of the upper arm bone firmly within the shallow socket of the shoulder)
  • Bursa (a lubrication sac sitting between the humerus and the acromion, the technical name for the outward end of the shoulder blade) 

Symptoms

Shoulder impingement typically causes pain in the front of the shoulder, especially when you lift and lower your arm. The area may become swollen and tender.

Others symptoms include:

  • Pain that radiates beyond the shoulder and down the arm
  • Sudden pain when lifting or moving
  • Pain when sleeping
  • Loss of strength and range of motion
  • Difficulty performing simple activities, such as zippering and buttoning a coat

Treatment options

Shoulder impingement can be treated one of two ways: with surgical methods or with nonsurgical methods. The type of treatment your physician chooses will depend on how advanced your case is. Since pain is minor at the beginning stages of the condition, many patients do not seek help right away, resulting in more advanced stages of shoulder impingement and a need for surgery. Be sure to see your doctor if you have any kind of persistent shoulder pain.

Nonsurgical treatment

Nonsurgical treatment for shoulder impingement can include:

  • Painkillers and anti-inflammatory medications
  • Physical therapy to strengthen the muscles surrounding your rotator cuff
  • Resting the shoulder to allow healing
  • Steroid injections

Surgical treatment

Surgery can be performed on more advanced cases to create more space for the rotator cuff. There are two surgical techniques used for treating shoulder impingement:

  • Arthroscopic surgery, a type of minimally invasive surgery that allows surgeons to repair tears and dislocations in the joints with superfine tools
  • Traditional open surgery

Arthroscopic surgery is usually done on an outpatient basis and doesn’t require as much healing time as open surgery. Because it is more invasive, open surgical repair may require a short hospital stay. Be sure to follow your physician’s guidelines on when to stop eating and drinking prior to the surgery, when to take any medications and how to best prepare for your procedure.