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Shoulder Impingement

A Shoulder Impingement, also known as tennis shoulder, swimmer’s shoulder, or bursitis as well as rotator cuff tendonitis or supraspinatus tendonitis, is a common cause of adult shoulder pain. Impingement occurs because the rotator cuff tendon and bursa are compressed when lifting the arm, rubbing on the overlying acromion bone in the shoulder blade and causing inflammation.

The main symptom of a shoulder impingement is pain with movement of the arm, particularly lifting and rotating it. There is loss of strength and pain during activity, but it can also be painful at rest. Activities like brushing hair, as well as sleeping on the affected shoulder can become very troublesome, and the condition can carry on for weeks.

It is important to get a diagnosis for shoulder impingement, as a frozen shoulder can cause similar symptoms but should be managed differently. When caught early, immediate treatment for a shoulder impingement injury should lead to a full and successful recovery.

For more information on shoulder impingement and possible treatment options, call +44 (0) 203 195 2442 to arrange a consultation with the London Shoulder Specialists.

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Causes of Shoulder Impingement

This injury is most likely to happen in sports where the arm is repeatedly lifted and rotated, as the alternative names suggest, sometimes in swimming and tennis. But it can also be caused by an injury, lifting heavy objects or alongside a partial tear of the rotator cuff.

In older adults, the rotator cuff degenerates with age and bony spurs can develop under the arch of the bone under the shoulder joint (your acromion).

These spurs can press on the tendons when moving the arm into certain positions – such as reaching up behind the back. This can make everyday tasks like clasping a bra, extremely painful.

Treating Shoulder Impingement

The non-surgical treatment options for shoulder impingement are normally successful. This can include resting from activity, ice packs and anti-inflammatory medicine. Physical therapy to regain strength and mobility in the shoulder can support a faster return to normal activities. If the inflammation continues, cortisone injections to the subacromial space is recommended.

If pain and inflammation in the shoulder does not resolve, a London Shoulder Specialists consultant can assess the severity of the damage. They will carry out a thorough physical examination, as well as X-ray or MRI scan to assess the extent of damage including if there is a rotator cuff tear. After this, your consultant can advise you on the most appropriate treatment plan, including surgical and non-surgical options, that will give you the best possible outcome.

Frequently Asked Questions on Shoulder Impingement

As a last resort, surgery may be recommended when a shoulder impingement fails to improve within 3 to 6 months after non-surgical treatment has been unsuccessful. Usually, depending on the extent of damage, an arthroscopic procedure (keyhole surgery) is performed called an arthroscopic subacromial decompression. This procedure will trim the acromion bone to allow the rotator cuff to move more easily. It will also remove or repair the rotator cuff tendons if they have been torn and to remove any bony spurs.

After surgery, it will normally take up to 12 weeks for a full recovery and a return to sports/normal activities. You will be provided with aftercare advice, including dressing care. You will be given a programme of strengthening exercises, directed by a physical therapist.

If you have further questions about possible treatment options for a shoulder impingement, please arrange a consultation with the London Shoulder Specialists.

At first, the shoulder is usually only painful when it is in motion. However, this may then develop into a constant dull pain that starts to affect sleep and prevents you enjoying your normal activities.

If left untreated, shoulder impingement can lead to inflammation of the rotator cuff tendons and the bursa, known as bursitis, which is inflammation of the cushioning fluid-filled sacs at the shoulder joint. Rotator cuff tendonitis can lead to a partially or completely torn tendon.

The average recovery for shoulder impingement is six to eight weeks and you can support recovery with non-surgical treatments such as anti-inflammatory medications, cortisone injections and the appropriate physical therapy. Resting the shoulder and avoiding repetitive overhead movements is important. However, severe impingements can take from six months to a year to fully recover.