Shoulder > Impingement Syndrome

What is Shoulder Impingement Syndrome?

Shoulder impingement syndrome is a condition that occurs when the rotator cuff, the muscles and tendons that raise and rotate your arm, become pinched beneath the acromion, which is the part of the your shoulder blade that makes up the "roof" of your shoulder.

Impingement syndrome usually stems from repeated stress to the shoulder caused by activities that involve throwing or raising the arm. Sports that require motions that can lead to shoulder impingement syndrome include baseball or softball, swimming, tennis, and skiing. Prolonged wear and tear on the shoulder joint can lead to bone spurs on the acromion, which can worsen impingement by further reducing the space between the acromion and rotator cuff.

Many patients respond well to non-operative treatment which includes rest, NSAID'S, physical therapy to improve flexability and strength of the shoulder and a cotisone injection. Patients who have persistent pain following non-operative treatment may benefit from arthroscopic subacromial decompression, a surgical procedure that removes the inflammed tissue (bursitis) and a spur on the front edge of the acromion.

Your physician will ask about your activities, which may have caused your shoulder pain. You will be asked when the soreness or pain began, where in your shoulder it occurs, how long it lasts, and what lessens or worsens it. If you have had any prior shoulder injuries, your physician will ask about the treatments you have tried in the past. Physicians also typically ask about other conditions, such as arthritis, diabetes, and allergies, and medications currently being taken. You may also be asked about your physical and athletic goals – information that will help your physician decide what treatment might be best for you in achieving those goals.

Your physician will palpate, or feel with the fingers, your shoulder for areas of tenderness. Your shoulder’s range of motion will be evaluated by raising your arm and rotating it toward and away from your body. These movements are performed while you are sitting up or lying on your back. You also may be asked to reach behind your back with the affected arm and hold that position. To determine if you are suffering from impingement syndrome specifically, your physician may press on your shoulder blade with one hand while raising your arm above your head. If this test produces pain, shoulder impingement is likely. In some cases, physicians will perform this test again after injecting a local anesthetic into your shoulder to confirm the diagnosis.