Shoulder Impingement: Causes and Treatment

Shoulder impingement occurs when the rotator cuff tendons and/or the subacromial bursa are compressed between the acromion (part of the shoulder blade) and the head of the humerus (upper arm bone). This compression leads to pain and inflammation, especially during overhead activities.

Causes of Shoulder Impingement

1. Repetitive Overhead Activities:
   • Common in sports like swimming, tennis, and baseball, as well as occupations requiring repetitive arm motions (e.g., painting, carpentry).
2. Poor Posture:
   • Forward head posture and rounded shoulders narrow the subacromial space, increasing the risk of impingement.
3. Rotator Cuff Weakness or Imbalance:
   • Weak or imbalanced rotator cuff muscles can lead to improper movement of the shoulder joint, causing impingement.
4. Bone Spurs:
   • Extra bone growth on the underside of the acromion can reduce the subacromial space, exacerbating compression.
5. Shoulder Instability:
   • Loose or unstable shoulder joints can alter biomechanics, leading to impingement.
6. Age-Related Degeneration:
   • Tendons and the bursa become less resilient with age, making impingement more likely.
7. Previous Shoulder Injuries:
   • Trauma or rotator cuff tears may predispose the shoulder to impingement.
8. Overuse or Improper Exercise Technique:
   • Incorrect weightlifting or overtraining can overload the shoulder joint, causing inflammation and narrowing of the space.

Symptoms of Shoulder Impingement

• Pain in the front or side of the shoulder, especially during overhead or lifting movements.
• Weakness or difficulty reaching behind the back.
• Pain at night, particularly when lying on the affected shoulder.
• Limited range of motion.
• Clicking or popping sensations during movement.

Treatment Options for Shoulder Impingement

Non-Surgical Treatments

1. Rest and Activity Modification:
   • Avoid aggravating activities, especially those involving repetitive overhead motions.
2. Ice Therapy:
   • Apply ice for 15–20 minutes to reduce inflammation and pain.
3. Anti-Inflammatory Medications:
   • NSAIDs (e.g., ibuprofen) to manage pain and swelling.
4. Physical Therapy:
   • Stretching Exercises: Improve flexibility in the shoulder and chest muscles.
   • Strengthening Exercises: Focus on the rotator cuff and scapular stabilizers to enhance shoulder mechanics.
   • Postural Training: Correct posture to reduce compression on the tendons and bursa.
5. Corticosteroid Injections:
   • Injecting steroids into the subacromial space to reduce severe inflammation and pain.
6. Ultrasound or Laser Therapy:
   • Promote tissue healing and reduce inflammation.

Surgical Treatments (For Severe or Persistent Cases)

1. Subacromial Decompression:
   • Removing bone spurs or reshaping the acromion to create more space for tendons and bursa.
2. Rotator Cuff Repair:
   • Repairing damaged rotator cuff tendons if impingement has caused a tear.
3. Bursectomy:
   • Removing the inflamed bursa to alleviate symptoms.

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Prevention Tips for Shoulder Impingement

1. Maintain Good Posture:
   • Avoid slouching or forward shoulder positions.
2. Strengthen the Rotator Cuff and Scapular Muscles:
   • Regularly perform exercises that improve shoulder stability and mechanics.
3. Avoid Overuse:
   • Limit repetitive overhead motions and ensure proper technique during activities.
4. Stretch Regularly:
   • Keep the shoulder and chest muscles flexible to prevent tightness.
5. Warm-Up Before Physical Activity:
   • Prepare the shoulder for exercise or sports to reduce strain.
6. Seek Early Treatment:
   • Address shoulder pain promptly to prevent worsening of the condition.