Shoulder impingement syndrome is sometimes called swimmer’s shoulder or thrower’s shoulder, and is caused by the tendons of the rotator cuff becoming impacted as they pass through a narrow bony space called the subacromial space of the shoulder joint. The subacromial space is so called because it is under the arch of the acromion. With repetitive pinching, the tendons continually rub against bone and become irritated and inflamed. This can lead to thickening of the tendon, which may cause further problems because there is very little free space, so as the tendons become larger, they are impinged further by the structures of the shoulder joint and the muscles themselves.
Cause
Shoulder impingement syndrome is typically caused by excessive use of the shoulder. Occupations such as painting or construction, which require repetitive overhead motions, are common culprits.
Symptoms
Symptoms of shoulder impingement syndrome include pain on the outside of the shoulder as well as difficulty raising the arm up out to the side and above the head; in particular, pain when moving the arm out to the side at a 60-degree arc. Additional symptoms include:
- Generalized shoulder aches
- Difficulty sleeping because of pain
- Pain may be present even when the shoulder is at rest
- Stiffness in the shoulder joint
- Sudden, sharp pain may be felt when the arm is used
- Catching sensation when raising the arm overhead
- Weakness in the arm, with reduced ability to raise the arm overhead
Treatment
Nonsurgical
- Anti-inflammatory medication
- Cortisone injection into the rotator cuff tendon or the bursa
- Physical therapy consisting of modalities to decrease pain and/or inflammation, stretching exercises, and strengthening exercises for the rotator cuff, as well as functional retraining to avoid further or repeated injury
If nonsurgical options do not relieve the symptoms, surgery may be needed to create space in the shoulder.