Dr. Devendra Dave

Shoulder impingement occurs when there is impingement or change in the position of the tendons or a bursa (fluid filled sac or cavity, which causes friction in the joints) in your shoulder. Repeated overhead exercises or intense physical activity concentrated around your shoulder is a common risk factor for shoulder impingement. The examples of such activity would include playing outdoor sports like tennis, swimming etc. or painting for long hours.

How it may affect your daily life?
Shoulder impingement pain is severe in many cases and may affect your everyday activities. In fact, any activity, which involves your shoulders can cause intense pain. You should visit a doctor or a professional medical facility to get relief from pain as well as to avoid aggravating the injury.

Symptoms of shoulder impingement:

• You will have difficulty in completing tasks which involve your back.
• There may be a weakness in your shoulder muscles.
• Pain associated with overhead use of your arm. Anytime you lift your arm there would be pain and would make many day to day activities difficult.
• Intense injury to the tendons can cause them to tear into two and would result in a rotator cuff injury and would make your arm movements next to impossible.

Diagnosis of shoulder impingement:
Physical exam and review of medical injury previously sustained on some other occasion is the first step of treatment. Your doctor may also diagnose shoulder impingement by X-rays or MRI of shoulder to see changes in the bone that may indicate any injury. Other changes in the normal contour of the bone may also be checked which may help in further diagnosis and treatment.

Treatment of shoulder impingement:

NSAIDs are anti-inflammatory medicines that are commonly prescribed for shoulder impingement syndrome. These are prescribed for two weeks. Shoulder impingement requires a long time to heal and would require regular consultation with your doctor. If the medications fail to provide any relief in a span of maximum two weeks it may compel your doctor to change the course of treatment. Shoulder impingement is a serious injury and requires proper rest for your shoulder as well as patience as it may take quite some time to come back to normal.

Physiotherapy for Impingement-

Physiotherapy is usually the first line of treatment for subacromial impingement (tendonitis, bursitis) of the shoulder; along with anti-inflammatories and analgesia. It is very successful in treating shoulder impingement syndrome. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include:

1. Pain Management
2. Manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches to get your shoulder moving properly.
3. You will learn exercises and stretches to help your shoulder and shoulder blade move properly.
4. Strengthening Exercises
5. The therapist will teach you the proper posture which is an important part of rehabilitation

In case you have a concern or query you can always consult an expert & get answers to your questions!

Osteogenesis Imperfecta or brittle bone disease weakens bones and causes them to break easily. This condition is frequently seen in children at birth, but it only develops in children who have a history of brittle bone disease in their family. Depending on the severity of the development of the disease, children can face anything from a couple of bone fractures to hearing loss, problems in the spinal cord, permanent deformation of bone structure, and heart failure. About one in every 20,000 babies develops brittle bone disease and it is equally spread out throughout different ethnic groups and genders.

Causes
It is caused due to a defect in the gene that helps in the production of type 1 collagen, which is a protein used in the creation of bones. This defect of gene is hereditary and is thought to be caused due to certain genetic mutations.

Types
There are four main types of brittle bone disease, namely Type 1 OI, Type 2 OI, Type 3 OI, and Type 4 OI.

• Type 1 is the most common and mild with development of fragile bones that are prone to fracture, and teeth problems such as cavities and dental cracks. It is not common among adults.
• Type 2 is the most severe form of the disease and potentially fatal. The body is unable to produce needed collagen resulting in formation of narrow chest, underdeveloped lungs and ill structured ribs in babies.
• Type 3 OI results in fracture in bones in children even before birth and may result in worsening of bone structure deformities as the child grows up.
• Lastly, Type 4 has symptoms both severe and mild. It is similar to Type 3 as it is caused due to production of lower quality collagen. Children suffering from this type of brittle bone disease are born bow legged, but the condition reduces over time.

Symptoms
The symptoms experienced by patients suffering from this condition vary from type to type. It is common knowledge that the most glaring symptom is fragility in bones, but there are many other symptoms that may appear as the cases grow more severe. Some patients report development of deformities, while others experience fractured bones without apt injuries. Loose joints, bowed arms and legs, week teeth, abnormal curving of the upper section of the spine, scoliosis, loss of hearing, heart defects, blue sclera (thinning in the collagen fibers), and respiratory issues are also frequently documented symptoms.

In case you have a concern or query you can always consult an expert & get answers to your questions!