Shoulder Impingement

///Shoulder Impingement

How Shoulder Impingement Causes Shoulder Pain

Shoulder pain is one of the most common complaints heard by orthopedic physicians and sports medicine specialists. One of the most common causes of pain is shoulder impingement. Impingement of the shoulder occurs when the rotator cuff tendons rub on a spur on the acromion above particularly when the arm is elevated above shoulder level. The continuous  or repetitive pinching leads to shoulder inflammation, pain and swelling. Located in the Van Nuys, Thousand Oaks and Los Angeles, California area, Dr. Mark Getelman, shoulder specialist, places in emphasis in orthopedic shoulder conditions, such as shoulder impingement syndrome.

The highest tendon of the rotator cuff, known as the supraspinatus tendon, passes beneath the bone on the top of the shoulder, known as the acromion. In certain patients, the space between the undersurface of the acromion and the top of the humeral head is quite narrow.  In these cases, the rotator cuff tendon and the adherent bursa can become pinched when the arm is raised into a forward position. With repetitive arm movements, the tendons and bursa can become inflamed,  swollen and potentially torn, leading to shoulder pain and weakness.

Individuals who perform repetitive overhead arm movements during work or sports activities tend to have an elevated risk of developing shoulder impingement. Swimmers and other athletes are prone to this shoulder injury, also known as “swimmer’s shoulder,” from the repetitive overhead motions. Other causes of impingement of the shoulder include an injury where the shoulder experiences compression, shoulder osteoarthritis, acromion bony abnormalities and poor rotator cuff muscle strength.

Shoulder Impingement Symptoms

The majority of patients report pain as the most common symptom associated with impingement of the shoulder. The pain typically intensifies at night leading to a loss of sleep quality in patients. Shoulder impingement pain can be felt on the outside of the upper arm and over the front of the shoulder and increases with overhead activity. Other common symptoms include weakness and a grinding sensation.

Shoulder Impingement Diagnosis

Impingement of the shoulder is diagnosed by Dr. Getelman during a physical examination and with special X-rays to evaluation the subacromial space to assess impingement and often an MRI scan to assess the extent of concurrent soft tissue injury. During the physical examination, Dr. Getelman will perform special impingement tests to confirm the diagnosis.

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Shoulder Impingement Treatment

Patients are encouraged to report shoulder pain and weakness as soon as it occurs so proper treatment can be prescribed by Dr. Getelman and his orthopedic team.

Non-Surgical

Non-surgical measures alleviate shoulder impingement symptoms in many patients. Dr. Getelman typically recommends rest, activity modification and anti-inflammatory medications to reduce inflammation and pain. Physical therapy, including range of motion and strengthening exercises, is recommended in many cases to strengthen the shoulder joint and increase range of motion. Dr. Getelman may utilize an ultrasound guided injection of corticosteroid to the affected area if the pain continues in an attempt to eliminate the pain and potential need for shoulder surgery.

Surgical

An arthroscopic shoulder surgery may be recommended if an acromial bone spur or thickened acromion is causing impingement of the shoulder. The bone spur or thickened acromion can be removed in a minimally invasive, outpatient procedure. Dr. Getelman can also repair any minor damage or rotator cuff tendon fraying during the same shoulder procedure.

For more information on shoulder impingement, or for additional resources on arthroscopic shoulder surgery, please contact the orthopedic office of Dr. Mark Getelman, shoulder specialist located in the Van Nuys, Thousand Oaks and Los Angeles, California area.