Hello! Do you sometimes feel a sharp pain in your shoulder? For example, when you try to raise your arm, pick something up, or turn to one side while sleeping at night? You may not pay much attention to this pain. But this can be a symptom of a condition called `Shoulder Impingement` , which is when parts of the shoulder are pushed from the inside. Today, we will talk about this in detail, very simply.
What is `Shoulder Impingement`?
Simply put, Shoulder Impingement is a condition in which your rotator cuff, located just below the outer edge of your shoulder blade (scapula), becomes irritated. Doctors sometimes call this Impingement Syndrome. Impingement is the rubbing, pinching, or rubbing of parts inside a joint. This is what causes pain, especially when you move your shoulder.
Think about it, your `Rotator Cuff` is a group of four major muscles that connect your shoulder blade and the large bone in your upper arm (the `humerus`). You use this `Rotator Cuff` to raise your arm up and rotate your arm to the side and back.
The rotator cuff is located in a small space between your upper arm bone (humerus) and the top of your shoulder blade (acromion). This is why the rotator cuff is more likely to get caught between those two bones and become impinged. This impingement is called shoulder impingement.
If you have shoulder pain, or if you can't move your shoulder without pain, definitely see a doctor.
Are there different types of `Shoulder Impingement Syndrome`?
Yes, a doctor may classify this `Shoulder Impingement` condition as another specific problem. The main ones are:
`Rotator Cuff Tendinitis`
This is, as the name suggests, a condition called Tendinitis, which affects the tendons of the Rotator Cuff. Tendinitis is the inflammation or swelling of a tendon. There are four tendons that help your Rotator Cuff move your shoulder joint. Anything that damages or irritates these tendons can cause them to swell. This swelling is what causes shoulder impingement.
Shoulder Bursitis
Bursitis is an inflammation of a bursa, a small sac filled with fluid. This bursa is located around our joints and acts as a cushion. There is also a bursa between your rotator cuff tendon and your acromion bone, which helps reduce friction between the two. However, if this bursa becomes inflamed, it can also cause shoulder impingement.
Changes in the shape of the acromion bone
The acromion is normally flat. However, if your acromion is curved or bent like a hook, it can rub against the rotator cuff and cause shoulder impingement. Some people are born with this abnormally shaped acromion. Or, as they get older, bone spurs can develop.
How common is this condition?
According to researchers, shoulder impingement is the cause of about 50% of shoulder pain. This condition is especially common in athletes and people who work hard.
What are the symptoms of `Shoulder Impingement`?
The main and most common symptom of `Shoulder Impingement` is shoulder pain .
This pain is usually felt in the front of the shoulder. Also:
- It can hurt badly when you touch your shoulder.
- The pain can radiate from the front of the shoulder down the arm to the side.
- The pain may be worse at night , making it difficult for you to fall asleep or stay asleep.
Shoulder Impingement pain may increase with certain movements or positions. For example:
- When raising the arm straight up, above the head.
- When you raise your hand and lower it again.
- When you reach out to pick up something.
- When you sleep on the side that hurts.
- When you put your hand behind your back (like putting your hand in the back pocket of your pants, or twisting your hand to unzip a bag).
Special features of `Rotator Cuff Tendinitis`
Symptoms may vary slightly depending on the type of `Shoulder Impingement` you have. For example, in addition to shoulder pain, someone with `Rotator Cuff Tendinitis` may also have symptoms like:
- A feeling of tightness and tightness in the shoulder.
- Having swelling .
- Sometimes there is a change in skin color or redness.
- Hearing a "squeaking" sound or feeling something similar when you shake your shoulder.
What are the causes of shoulder impingement?
Most often, Shoulder Impingement is an overuse injury . This means that the condition develops gradually over time due to excessive pressure on the shoulder joint and the Rotator Cuff when performing the same movement repeatedly.
Doctors call this ``overhead rotation motions.'' That is, any repetitive motion that involves holding the arm overhead and rotating the shoulder. The main causes of this are training for a sport, or doing the same kind of movement all day at work.
Imagine, a cricket bowler keeps twisting his arm in the same way. Or a painter works by twisting his arm upwards all day. These are the things that put this pressure on the shoulder.
Some people can develop shoulder impingement idiopathically. It can also occur suddenly due to trauma, such as a fall, car accident, or sports injury.
Who is at higher risk of developing this? (Risk Factors)
Shoulder Impingement can happen to anyone. However, it is more common in athletes and people who work hard . It usually doesn't happen all at once, but develops gradually over weeks, sometimes months.
Types of sports that can cause `Shoulder Impingement`:
- Swimming
- Cricket (especially bowlers)
- Volleyball
- Tennis
This condition can be caused by any physically demanding job that puts pressure on the shoulders:
- Construction work
- Paintbrush
- Window cleaning
- Wallpapering, drywalling
How to diagnose shoulder impingement?
A doctor will diagnose shoulder impingement with a physical exam . He or she will examine your shoulder and check your range of motion (how far you can move it without pain). Tell your doctor what you were doing when you first felt the pain and other symptoms. If you do sports, hobbies, or work that put repetitive stress on your shoulder or arm, be sure to mention that as well.
Tests for Shoulder Impingement
Your doctor may also do several imaging tests to take pictures of the shoulder joint:
- `X-rays`
- `MRI (Magnetic Resonance Imaging)` (M.R.I.)
- Ultrasound
These imaging tests can give your doctor a clear picture of the bones and tissues in your shoulder joint. They can also help determine the exact cause of the impingement.
Not only that, these tests can also help determine if there are other causes of shoulder pain. For example:
- `Rotator cuff tears`
- Biceps tendon injuries
- Shoulder arthritis
How to treat a shoulder impingement? (`Treatment`)
Your doctor will recommend treatments to help control your symptoms, heal your shoulder, and get you back to normal shoulder function. The main treatments for shoulder impingement are:
- Rest: A period of time away from strenuous work, especially the sport or activity that caused the condition.
- Physical therapy: A physical therapist will give you stretches and exercises to strengthen your shoulder and improve your range of motion. As your shoulder heals, he or she will also give you exercises to strengthen your rotator cuff muscles.
- Icing: Wrap an ice cube or ice pack in a thin towel and place it on your shoulder. Never put ice directly on the skin. Your doctor will tell you how long to apply the ice and how many times a day to apply it.
- Pain relievers: Over-the-counter (OTC) NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can help reduce pain and swelling. However, do not take these medications for more than 10 days at a time without talking to a doctor.
- Corticosteroids: These are medications prescribed by a doctor to reduce inflammation (swelling and itching). Sometimes you may also need to get cortisone shots into the shoulder joint.
Will surgery be required for a shoulder dislocation?
If other treatments don't help your symptoms, your doctor may consider surgery. The surgeon may perform a procedure called an arthroscopic shoulder decompression. This involves inserting a camera and fine instruments through a few small incisions to remove a small piece of your acromion bone to make more room for the rotator cuff.
Your surgeon will explain to you in detail what kind of surgery you need and what the recovery period will be like afterwards.
What is the best treatment for `Rotator Cuff Tendinitis`?
Treatment for rotator cuff tendinitis is often similar to treatment for other types of shoulder impingement. Your doctor will tell you the best ways to help your rotator cuff tendon heal.
How soon will I feel better after starting treatment?
Most people start to feel better and less pain within a few weeks of starting treatment for shoulder impingement. However, even if your symptoms improve, you should not return to sports or strenuous activities until your doctor gives you the OK.
How long does it take for shoulder impingement to heal?
The recovery time from shoulder impingement depends on the type of impingement you have and how severe it is.
Although you usually start to feel better within a few weeks of starting treatment, it can take several months for your shoulder to fully heal. Some people may need up to a year of treatment and rehabilitation (`rehab`).
Can Rotator Cuff Tendinitis be completely cured?
Yes, all types of `Shoulder Impingement`, including `Rotator Cuff Tendinitis`, can be treated very well and cured. However, do not put off seeing a doctor as soon as you feel shoulder pain. If left untreated, `Shoulder Impingement` can worsen, lead to complications, or worsen the injury.
See a doctor as soon as you experience symptoms such as pain, swelling, or difficulty moving your shoulder.
How to prevent shoulder impingement? (Prevention)
The best way to avoid shoulder impingement is to avoid overusing your shoulders :
- Stop exercising or doing strenuous work as soon as you feel pain. Never play or work through pain.
- Do a good `warm up` (exercises to prepare the body) before strenuous work or sports, and `cool down` (exercises to calm the body) after you finish.
- Use appropriate safety equipment for all sports and physical activities.
- Follow a healthy diet and exercise plan that suits you.
- See a doctor as soon as you experience pain or other symptoms.
How do I take care of myself when I have `Shoulder Impingement`?
Do not resume strenuous activities until your doctor gives you the OK. If you put pressure on your shoulder, the rotator cuff, before it has had time to heal completely, you are more likely to injure it again. This can lead to more serious injuries, such as a torn rotator cuff.
When should I see a doctor?
If you experience any new pain, stiffness, or swelling in your shoulder – especially if the symptoms are getting worse, or if you have difficulty moving or using your shoulder or arm – see a doctor immediately.
If you have had an accident, are unable to move your shoulder, or if you think you have a dislocated shoulder, go to a hospital emergency room immediately. Never try to put your shoulder back in place on your own.
What questions should I ask my doctor?
You can ask your doctor these questions:
- Do I have shoulder impingement or another injury?
- What type of `Impingement` do I have?
- What kind of treatment do I need?
- Will I need surgery?
- How long should I stay away from sports and strenuous activities?
Finally, things to remember (Take-Home Message)
Shoulder Impingement can be caused by anything that irritates or inflames your rotator cuff and the tissues in your shoulder joint. Whether you have rotator cuff tendinitis, bursitis, or a structural problem with the bones of your shoulder, your doctor will recommend a combination of treatments to help relieve your symptoms and restore normal shoulder function.
Shoulder impingement can be painful and frustrating – especially if it takes you weeks out of your favorite sport or daily activities. However, never ignore symptoms like pain, tenderness, or difficulty moving your shoulder.
The sooner you get your shoulder checked by a doctor, the sooner you can safely and happily start doing the things you love again. Wishing you a speedy recovery!
` Shoulder Pain, Shoulder Impingement, Rotator Cuff Tendinitis, Shoulder Strain, Tendonitis, Shoulder Disorders, Physical Therapy
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