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Shoulder Impingement

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Recover from Shoulder Impingement, shoulder weakness with the latest non-surgical treatment options, including physical therapy, nonsteroidal anti-inflammatory drugs, steroid injections, and regenerative medicine procedures such as Prolotherapy. Our doctors are experts in treating shoulder pain and can pinpoint your pain source and prescribe a personalized, time-tested treatment plan that works. Visit our sports injury and pain management center to meet our physicians to get the shoulder pain relief you need in the safe, reassuring hands of the best doctors in New York.

Shoulder Impingement


Shoulder impingement

Shoulder impingement is a cause of shoulder pain that is very common. It is other referred to as swimmer’s shoulder or impingement syndrome, as it is very common in those who swim professionally. It is however also common in other athletes who have to use their shoulders a lot, such as softball players or baseball players.

The rotator cuff is a description for a group of tendons and muscles which attach the upper arm bone to the shoulder. The rotator cuff has the function of rotating the arm and lifting the arm. The rotator cuff is located under the top of the shoulder, other known as the acromion. When you suffer from shoulder impingement, narrow. This leads to an increased pressure in your shoulder, which can end up causing impingement.

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Our physicians might need to do an X-ray to rule out arthritis or to check for bone changes, such as a bone spur, which can also lead to impingement. If the doctor suspects that you might be suffering from a more serious rotator cuff injury or when your doctor needs further tests to diagnose your pain, you might need to get an MRI scan.

What are the symptoms of shoulder impingement?

The main symptom of shoulder impingement is a pain in the shoulder, which is very sudden and felt when you need to lift your arm backward or overhead. It is sometimes also accompanied by other symptoms, such as:

  • shoulder weakness
  • arm weakness
  • pain that worsens at night
  • pain that starts in the front of the shoulder and to the side of the arm
  • minor but constant pain in the arm

What is the cause of shoulder impingement?

There are many cases of shoulder impingement that are caused by overuse. Using the shoulder and doing repetitive motions can lead to the tendon in the shoulder swelling, which leads to them catching on the upper shoulder bone. In other cases, it might occur without a cause.

Are there risk factors for shoulder impingement?

Doing sports which require using the shoulders for forceful motion or overhead motion is one of the biggest risk factors that can lead to shoulder impingement.

Some common activities which can cause shoulder impingement, include:

  • baseball
  • tennis
  • swimming
  • heavy lifting

If you work at a job that involves a lot of arm movement or heavy lifting might also increase the risk of suffering from shoulder impingement. Such occupations include painting, moving boxes, construction work, and similar. Old age, as well as suffering from previous shoulder injuries, such as a dislocation, can also be a risk factor for shoulder impingement.

Some people are born with an unusually shaped acromion can also increase the risk of suffering from shoulder impingement.

How is shoulder impingement diagnosed?

The doctor might start by asking you some questions about your exercise habits and whether you’ve suffered previous injuries. You might be asked to do a series of motions that involve using your shoulder. Your doctor will check whether any unusual movement is visible. This can help your doctor to rule out other possible conditions, such as a pinched nerve.

There are two different types of shoulder impingement, such as:

  • primary
  • secondary

To differentiate between the two, there are different shoulder impingement tests, with the Neer test and the Hawkins test being the most popular ones.

During the Neer test, your physician will stabilize the scapula, while elevating the shoulder passively, impinging the humeral head into the acromion.

During the Hawkins test, your physician will elevate the arm to 90 degrees of abduction and force the shoulder into internal rotation, impinging the cuff under the subacromial arch.

There are also cases where you might need to do an X-ray to rule out arthritis or to check for bone changes, such as a bone spur, which can also lead to impingement. If the doctor suspects that you might be suffering from a more serious rotator cuff injury or when your doctor needs further tests to diagnose your pain, you might need to get an MRI scan.

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How is shoulder impingement treated?

There are many shoulder impingement treatment options. Which option will be beneficial in your case depend on how severe your condition is.

Resting is very important if you’re suffering from shoulder impingement. You must avoid any movements or strenuous exercise, which might worsen your pain. This is even more important to do if you’re an athlete. Although it is best to rest, it is also important that you avoid using a sling that will immobilize the arm completely, as this can only lead to more stiffness and more weakness.

Ice pack.
When you’re in pain, it is recommended to put an ice pack on the shoulder for up to 15 minutes at a time for a couple of times a day. This can help to provide pain relief and can reduce swelling.

Physical therapy.
Shoulder impingement can respond well to physical therapy. Shoulder impingement treatment physical therapy uses gentle exercise to rebuild the strength of the shoulder muscles and the range of motion. Your doctor might refer you to a physical therapist, which can specialize in shoulder injuries.

Your physical therapy sessions will most likely focus on working the muscles of the arm, the chest, and the shoulder. This can help to improve the function of your rotator cuff. If you are an athlete or if you work at an occupation that requires using the shoulder frequently, you can get instructions from your physical therapist on what techniques to use to reduce the chance of recurrence. You might also get some exercises from your physical therapist, which you can do at home and that can help your recovery. It is however very important that you don’t overdo it.

Anti-inflammatory drugs.
Your doctor might also recommend that you take nonsteroidal anti-inflammatory drugs, such as ibuprofen, which can help to reduce shoulder pain and swelling. If such medications, along with resting and icing doesn’t help to reduce your pain, you might need steroid injections.

Steroid injections.
A steroid injection can be administered in the doctor’s office. It has a powerful anti-inflammatory property and can be injected directly into the shoulder area. Steroid injections can help, not only as a shoulder impingement treatment but also for treating other conditions, such as frozen shoulder, inflammatory arthritis, or tendinitis.

Prolotherapy.
Prolotherapy is a regenerative medicine procedure that utilizes the body’s healing response to improve injuries, shoulder pain, and other conditions.

Surgery.
In cases where other treatments don’t work, you might need to get surgery. Surgery is done to widen the space around the rotator cuff. This allows the rotator cuff to move without rubbing or catching on the bone. Such a surgical procedure can be done with the use of minimally invasive arthroscopic surgery, however, severe cases need to be treated with the use of traditional open surgery. Rarely, shoulder impingement can complicate and lead to a rotator cuff tear. In such cases, you are likely to need surgery to repair that tear.

Shoulder impingement recovery time will depend on your case and its severity. Generally speaking, it takes around three to six months to completely heal. Severe cases might take as long as one year to heal. However, you are likely to be able to go back to your regular activities within two to four weeks. Once it’s safe for you to start being physically active, it is important not to overdo it. This can only lead to further injuries and can increase recovery time.

Although shoulder impingement can be a painful condition, which might affect your daily activities, you are more than likely to experience a full shoulder impingement recovery within a couple of months. In many cases, it will be enough to rest, get physical therapy, and other non-invasive methods, such as steroid injections. Only after all non-invasive options have failed, you might need to consider surgery.

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441616/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609372/
https://my.clevelandclinic.org/health/diseases/7079-shoulder-impingement-syndrome
https://www.nhs.uk/conditions/shoulder-impingement-syndrome/

For more information about Shoulder Impingement treatment or to schedule an appointment with the top sports medicine physician in Downtown, Brooklyn, and Lower Manhattan, please call our office for a consultation and indicate which location you want to visit.

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general information. In no way does any of the information provided reflect definitive treatment advice. It is essential to consult a best-in-class pain management specialist in New York regarding ANY questions or issues. A thorough evaluation should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call your pain doctor to schedule a consultation.

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  • Dr. Raj Raval, M.D.

    1. Board Certified
    2. Interventional Pain & Musculoskeletal Medicine Specialist
  • Education & training

    1. SUNY Downstate PMR Residency
    2. Rutgers University Fellowship
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