Overview
Shoulder impingement is a very common form of shoulder pain and occurs when a tendon inside the shoulder rubs or catches on nearby tissue and bone as you lift the arm. It affects the rotator cuff tendon. Your rotator cuff is a group of muscles and tendons that attach your upper arm bone to your shoulder. They help you lift and rotate your arm.
It is also known as impingement syndrome or swimmer’s shoulder since it’s common in swimmers and other athletes who use their shoulders a lot.
Symptoms
Shoulder impingement can start suddenly or come on gradually. The main symptom is sudden pain in the shoulder when you lift your arm over your head or backwards. Other symptoms include:
- pain in the top and outer side of your shoulder
- pain or aching at night, which can affect your sleep
- weakness in your arm
- minor but constant pain in your arm.
Your shoulder will not usually be stiff. If it is, you might have a frozen shoulder instead.
Causes
There is no known cause for impingement, but it occurs most frequently when there is an overuse of the shoulder. As for example in swimmers, painters or construction workers, where the arms are constantly in motion. This overuse can make the tendons in the shoulders swell causing them to catch on nearby tissue and bone.
How you can help yourself if you have shoulder impingement:
Avoid any activities that will make the pain worse.
Avoid activities that involve repeatedly lifting your arm above your head (eg swimming, painting, tennis).
Do not stop moving your arm completely. Instead, continue to carry out your normal daily activities as much as possible so your shoulder does not become stiff or weak.
Ice your shoulder for up to 20 minutes a few times a day.
Take painkillers such as an anti-inflammatory painkiller or paracetamol to reduce the pain and inflammation.
Treatment
Shoulder impingement usually responds well to physical therapy. This will include some working of the muscles around the shoulder, upper arm and chest area to improve the function of the rotator cuff; and exercises to rebuild strength and range of motion.
A non-steroidal anti-inflammatory tablet such as ibuprofen can help reduce swelling and shoulder pain.
Often a combination of physical therapy and anti-inflammatory pain relief will clear all problems.
However, if these medications, along with ice and rest, don’t reduce your pain, your doctor might prescribe steroid injections to reduce swelling and pain. In the worst cases, surgery may be required.