Shoulder Impingement & Rotator Cuff Tendinitis

Understanding Shoulder Impingement & Rotator Cuff Tendinitis

Shoulder impingement is one of the most common causes of shoulder pain. The rotator cuff tendons and the bursa, a fluid-filled sac that lets them glide, pass through a narrow space beneath the acromion, the bony tip of the shoulder. When the arm is raised, the tendons and bursa can be pinched against the acromion, becoming irritated and inflamed. Inflammation of the tendons is called rotator cuff tendinitis; inflammation of the bursa is subacromial bursitis. The two often occur together.

Impingement is common in swimmers, tennis players, painters, construction workers and others who use their arms overhead repeatedly. It also develops with age as tendons wear and bone spurs form under the acromion.

Most people improve with rest, physical therapy and sometimes an injection. When pain persists despite several months of nonsurgical care, an arthroscopic procedure can create more space for the rotator cuff.

Causes & Risk Factors

• Repetitive overhead activity in sports or work
• Bone spurs or a curved shape of the acromion
• Age-related rotator cuff wear
• Weak rotator cuff or shoulder-blade muscles and poor posture
• Minor injuries that start an inflammatory cycle

Symptoms

Common signs and symptoms of Shoulder Impingement include:

• Pain and swelling at the front or side of the shoulder
• Pain when lifting the arm out to the side or reaching overhead
• Pain that travels down the outside of the upper arm
• Pain at night, especially lying on the shoulder
• Loss of strength and motion as symptoms progress

Treatment Options

Treatment for Shoulder Impingement depends on the severity of your condition and may include:

• Rest and avoiding overhead activities that cause pain
• Physical therapy focused on rotator cuff and scapular strength and posture
• Anti-inflammatory medications
• Corticosteroid injection into the bursa
• Arthroscopic subacromial decompression for persistent symptoms