Shoulder impingement is a common condition that affects thousands of people every year. It is a syndrome that occurs when the tendons of the rotator cuff (a group of four muscles that come together as tendons to form a “cuff,” or cover, over the head of the upper arm bone), along with a bursa (small fluid-filled sacs that reduce friction between moving parts in your body’s joints), become compressed against a bony surface in the shoulder, leading to pain and restricted movement. This impingement can significantly affect your quality of life, limiting the ability to perform routine tasks and engage in physical activities you once enjoyed.
Understanding the Symptoms
Shoulder impingement can significantly disrupt your life. Recognizing its symptoms is the first step toward effective management. Usual symptoms include:
- Persistent Pain: Pain is the hallmark sign of shoulder impingement, especially noticeable when lifting the arm overhead. This can affect activities such as reaching for high objects, painting, or throwing a ball. As the condition worsens, the pain can escalate from a mild, intermittent ache to a constant and debilitating discomfort.
- Arm and Shoulder Weakness: This is a sign that the shoulder’s structure needs care. With shoulder impingement, individuals can find it increasingly difficult to lift objects, push open heavy doors, or maintain usual physical activities such as swimming or lifting weights.
- Difficulty Reaching Behind: This symptom can be a struggle to reach behind one’s back for tasks like tucking in a shirt, fastening a bra, or grabbing something from a back pocket. This limitation in movement often comes with a sharp, stabbing pain or a noticeable stiffness and restricted range of motion in the shoulder.
- Nighttime Pain: Shoulder impingement often becomes more noticeable during the night. This deep, aching pain can wake individuals from sleep and make it hard to find a comfortable position to lie in. Persistent sleep disturbance due to this pain should not be underestimated, as it can significantly impact overall health, mood, and daily functioning.
Causes and Risk Factors
Several factors can contribute to the development of this condition.
- Anatomical Abnormalities: This includes variations in the shape and structure of the bones in the shoulder area. For example, having a naturally hooked or curved acromion (part of the shoulder blade) can make you more prone to impingement, as it can create less space for the tendons to move freely.
- Repetitive Overhead Movements: Frequent overhead activities (such as painting, swimming, lifting weights, or playing overhead sports like tennis or volleyball) increase the stress on the shoulder tendons. This repetitive stress can lead to inflammation and impingement.
- Trauma or Injury to the Shoulder: A fall, accident, or sudden blow to the shoulder can cause immediate impingement or set the stage for it to develop over time, due to changes in the shoulder anatomy and mechanics.
- Aging: As we age, our tendons become less flexible and resilient, which makes them more prone to injury and impingement. Blood supply to tendons also decreases with age, slowing healing and potentially contributing to impingement.
- Poor Posture and Muscle Imbalances: Slouching or hunching, often aggravated by long hours at a desk or poor ergonomics, can lead to muscle imbalances around the shoulder. This altered posture can decrease the space where the tendons glide, making impingement more likely.
Treatment Options for Shoulder Impingement
The discomfort and limitation can be frustrating when grappling with shoulder impingement. So, what are your treatment options?
- Physical Therapy: Physical therapy can help restore normal movement in your shoulder, strengthen the muscles that support it, improve posture and overall shoulder function, and reduce pain.
- Anti-inflammatory Medications: Anti-inflammatory medications can bring immediate relief and help reduce the inflammation. They work by reducing inflammation in the shoulder, alleviating pain to a manageable level, and making it easier for you to move and use your shoulder.
- Corticosteroid Injections: For more severe cases of shoulder impingement where pain and inflammation are extensive, corticosteroid injections deliver a powerful anti-inflammatory medication directly to the site of pain and swelling. They can provide rapid and sometimes dramatic relief and are typically used when other treatments haven’t yielded enough improvement.
- Surgery: When conservative treatments don’t resolve the issue, surgery may be considered. The goal of surgical intervention is to create more space for the inflamed tendons, often by removing a small part of the bone that contributes to the impingement, repairing any damaged tendons or ligaments, and allowing for a full, pain-free range of movement in the shoulder.
Prevention and Self-Care
For individuals who have already experienced shoulder impingement and those at risk, it’s important to focus on prevention and self-care. Here are strategies that can help safeguard your shoulder health:
- Regular Shoulder Strengthening Exercises: Engaging in consistent exercises that target and strengthen the muscles around the shoulder is essential. Stronger muscles can better support the shoulder joint, reducing the risk of impingement. Consult with your orthopedist or physical therapist for a tailored exercise plan. They can create a program that meets your needs and limitations, ensuring the exercises are performed safely and effectively.
- Mindful Posture During Desk Work: Maintaining an upright posture, especially when seated for extended periods at a desk, can play a significant role in maintaining your shoulder health. Simple adjustments (such as aligning your back with the back of your chair and keeping your feet flat on the floor) can promote a more neutral spine and shoulder position. This reduces the extra stress a slouched posture places on the shoulder muscles and tendons.
- Moderation of Repetitive Overhead Activities: Continuous overhead motions can aggravate or contribute to shoulder impingement. If your occupation or hobbies involve these movements, taking frequent breaks to rest the shoulder is essential. Alternating tasks and periodically stretching can significantly reduce the risk of impingement.
- Ice Application After Excessive Shoulder Use: Applying an ice pack to the area can help reduce pain and swelling after heavy shoulder use or if you start to feel discomfort. Icing can reduce swelling, numb the area to reduce pain, and promote faster healing.
Integrating these practices into your daily life helps to prevent shoulder impingement and contributes to overall shoulder health and functionality.
If you have been experiencing shoulder pain, please do not delay care. Dr. Peter Howard can help you regain the mobility you’ve lost. Contact us today to schedule your appointment.