Impingement Syndrome

Also Known as:

Trapped Tendons, Tendinitis, Bursitis

What is it?

The four muscles that raise and lower the arm (and their respective tendons) are collectively known as the rotator cuff. This group of tissues fits neatly under the roof of the shoulder (an extension of the shoulder blade known as the acromion).

If the cuff becomes inflamed, or some bone deformity (usually a bone spur) exists in the acromion, the rotator cuff and acromion can rub against one another, causing a painful condition known as impingement. Each time the arm is raised there is a bit of rubbing on the tendons and the bursa (small fluid-filled sacs located in the shoulder to lubricate the joint and reduce friction) between the tendons and the acromion, which may cause pain and inflammation.

Almost everyone will experience some degree of impingement due to the day-to-day activities that we perform with the arm above shoulder level. Impingement may become a serious problem for some people and disturb their normal activities. This is when treatment is needed.

The impingement process may get worse if any condition decreases the amount of space between the acromion and the rotator cuff tendons or if bone spurs are present.

Treatment

Treatment of impingement syndrome involves:

1.       Painkillers and anti-inflammatory medications

2.       Physiotherapy - keeps your shoulder strong and flexible and reduce the irritation

3.       Injections - reduces inflammation and control the pain

Rarely Surgery is required - the goal of any surgery to reduce the effects of impingement, by  increasing the amount of space between the acromion and the rotator cuff tendons, which will then allow for easier movement and less pain and inflammation. The operation performed is Arthroscopic Subacromial Decompression (ASD)

Prevention

o        Avoid excessive overhead activities.

o        Strengthen your shoulders and do not try to play or work through the pain.

Terms Explained:

Bone Spurs = small deposits of calcium, which build up along the edges of the bones. If they become big enough, or are further complicated by conditions such as impingement, they can become quite painful as tendons and other native tissues within the shoulder joint rub against them, causing inflammation and pain