Shoulder impingement is the most prevalent cause of shoulder pain and is commonly known as a swimmer’s shoulder since it’s common in swimmers. Other athletes, such as baseball or softball players who use their shoulders, often experience shoulder impingement. The shoulder consists of a rotator cuff which sits under the top of the shoulder. The rotator cuff is a group of muscles and tendons that attach the upper arm bone to the shoulder. These muscles and tendons help you lift and rotate your arm. 

In shoulder impingement, the rotator cuff catches or rubs against the acromion(the top of the shoulder). While lifting the arm, the space between the rotator cuff and acromion narrows, which increases pressure, thus irritating the rotator cuff, leading to impingement.

Shoulder impingement symptoms

If you experience sudden pain when you lift your arm overhead or backwards, you should consult a shoulder specialist such as Dr Chandra Sekhar B. Other symptoms to watch out for during shoulder impingement include:

• Minor but constant pain in your arm
• Pain that goes from the front of your shoulder to the side of your arm
• Pain that gets worse at night
• Shoulder or arm weakness

What causes shoulder impingement?

Overuse is the primary cause of shoulder impingement. When the shoulder is repeatedly used, the tendons in your shoulder swell, leading them to “catch” on your upper shoulder bone. 

Sports or professions where the shoulders are used over the head often, and that too with force, are the biggest risk factors for developing shoulder impingement. Common activities that could cause this include:

• Swimming
• Tennis
• Baseball
• Construction Work
• Moving Boxes
• Painting
• Old age 
• Repeated minor shoulder injuries
• Earlier shoulder dislocation. 
• Anatomical abnormalities of the shoulder, such as unusually shaped acromion.
• Shoulder impingement treatment options 

Diagnosis of shoulder impingement

The treatment for shoulder impingement starts with a basic routine health check-up by your doctor. On the first visit, your doctor will inquire about your medical history, previous injuries, and daily routine. They will ask you to do a series of motions with your shoulder, and they will observe your movements for any abnormality. Doctors will also figure out if there is a pinched nerve.

An x-ray is also taken to rule out arthritis or check for bone changes, such as a spur. Bone spurs could cause shoulder impingement.

If a serious rotator cuff injury is detected, they might use an MRI scan to get a better look at your shoulder.

Many types of treatment are available for shoulder impingement, depending on how severe your case is.

Treatment options for shoulder impingement

Self-care at home

One can start self-care by resting and avoiding strenuous exercise or any movements that worsen the pain. 

Do not use a sling to immobilize your arm completely. Arresting the movement with a sling leads to more weakness and stiffness in your shoulder.

Apply ice to your shoulder for 10 to 15 minutes at a time, a few times a day, to reduce pain and swelling.

Physical therapy

Physical therapy is a go-to choice of treatment to cure shoulder impingement. Physical therapy helps to rebuild shoulder strength and range of motion. The physical therapist will focus on improving the function of the muscles in your shoulder, arm, and chest, i.e. the rotator cuff. For a professional sportsperson or one in a profession with a lot of physical work, your physical therapist can teach you proper techniques to reduce your chance of recurrence.

Initially, you can go to the therapy place to do the exercises. But once you gain confidence, you can do them at home for faster recovery. Be cautious of overdoing the exercises.

Medication

Take doctor-recommended Nonsteroidal anti-inflammatory drugs to reduce swelling and shoulder pain. If none of the above techniques is helping with pain, your doctor might prescribe steroid injections to reduce swelling and pain.

Surgery for shoulder impingement

As the last option, you may need surgery to widen the space around your rotator cuff for free movement without catching or rubbing on your bone. Minimally invasive arthroscopic surgery is sufficient for most cases. Only for severe cases traditional open surgery is performed. 

If there is a rotator cuff tear, you’ll likely need surgery to repair the tear.

After the shoulder surgery, you may need to briefly wear an arm sling, even for minimally invasive surgery. 

Recovery time from Shoulder impingement 

Complete healing from shoulder impingement usually takes about three to six months, and more severe cases can take up to a year to heal. Within two to four weeks, you can return to your daily activities. Do not overdo your normal activities, too, as this will adversely affect your total recovery time or lead to other injuries.

Do’s and don’ts during recovery from shoulder impingement

• Avoid activities that involve throwing, especially with your arms over the head, such as tennis, baseball, and softball. 
• In the gym, avoid overhead presses or pull-downs. 
• For those with swimming as a regular exercise or a profession, take some time off from training to allow the recovery process to progress.
• Balance between rest and exercising to strengthen your rotator cuff and stretch your arm, shoulder, and chest muscles.

Recovery from shoulder impingement requires proper rest, regular follow-up, and patience to give the shoulder sufficient time to heal. Surgery will not be needed if the patient follows the doctor’s guidance religiously and practices regular physical therapy in most cases. But the surgeon might go for arthroscopic or fully open surgery when trauma or a tear is involved. Our doctors at Hyderabad Shoulder Clinic have years of expertise in treating people of various professions who use their shoulders excessively and experience shoulder impingement. For more information, please visit our website Orthopedic Hospital in Hyderabad | Orthopedic Surgery | Dr Chandrashekar (hyderabadshoulderclinic.com), or contact us at +91 9959588389, shoulderandsportsclinic@gmail.com