Shoulder impingement is a common diagnosis, yet is an often misunderstood condition that affects many individuals, from athletes to desk workers. Understanding what shoulder impingement is, its causes, symptoms, and treatment options can help you with management and prevention.

What is Shoulder Impingement?
Shoulder impingement is believed to occur when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space, the narrow passage beneath the acromion (part of the shoulder blade). This space can become even narrower when the arm is lifted, leading to increased pressure and pain.
Causes of Shoulder Impingement

Several factors may be contributing to the development of shoulder impingement, including:
Overuse and Repetitive Movements: Repetitive overhead activities, such as swimming, tennis, or painting, can lead to overuse of the shoulder muscles and tendons, causing irritation.
Poor Posture: Slouching or maintaining a forward-leaning posture can alter the alignment of the shoulder blade and reduce the subacromial space.
Age-Related Changes: As we age, the tendons of the rotator cuff can degenerate, becoming more susceptible to inflammation and tears.
Structural Abnormalities: Bone spurs or variations in the shape of the acromion can narrow the subacromial space, increasing the risk of impingement.
Muscle Imbalances: Weakness or imbalance in the shoulder muscles can lead to improper movement patterns, contributing to impingement.
Symptoms of Shoulder Impingement
The symptoms of shoulder impingement can vary in intensity but typically include:
Pain: Pain in the front or side of the shoulder, especially when lifting the arm, is a common symptom. This pain may extend down the arm.
Weakness: Weakness in the shoulder or difficulty lifting the arm above the head can occur.
Stiffness: Reduced range of motion and stiffness in the shoulder joint may be present.
Tenderness: The shoulder may be tender to the touch.
Clicking or Popping: Some individuals may experience a clicking or popping sensation when moving the shoulder.
Diagnosis
A healthcare professional will diagnose shoulder impingement through a combination of medical history, physical examination, and imaging tests. During the physical exam, specific movements and tests will be performed to assess pain and range of motion. Imaging tests like X-rays, ultrasound, or MRI may be used to rule out other conditions and to examine the shoulder’s structure in detail.
Treatment Options
Treatment for shoulder impingement aims to reduce pain and inflammation, restore normal function, and prevent recurrence. Common treatment options include:
Activity Modification: Modifying activities that exacerbate the symptoms is crucial.
Physical Therapy: A physical therapist can design a program of stretching and strengthening exercises to improve shoulder mechanics and reduce impingement.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
Corticosteroid Injections: In some cases, corticosteroid injections may be administered to reduce inflammation and pain.
Surgery: If conservative treatments fail to alleviate symptoms, surgical options such as arthroscopic decompression may be considered to increase the subacromial space and relieve impingement.
Prevention
Preventing shoulder impingement involves performing regular shoulder-strengthening exercises and focusing on sound biomechanical principles. Ensuring proper technique in sports and other physical activities can also help prevent the development of impingement.
Shoulder impingement is a treatable condition that, if addressed early, can be managed effectively with a combination of rest, physical therapy, and lifestyle modifications.
If you or someone you know may be dealing with something similar to shoulder impingement, then text Dr. Anthony Harrell at 661-378-3206 and see how we can help you with our rehab coaching programs.
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