Dr. Sarla Sindhu

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:
1. You will have difficulty in completing tasks which involve your back.
2. There may be a weakness in your shoulder muscles.
3. 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.
4. 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

The shoulder is one of the most important joints in the body that uses a ball and socket to join the arm to the rest of the body. Any pain can make it difficult to carry out motion in a comfortable manner. The shoulder consists of the long arm bone called the humerus, the collarbone or the clavicle, as well as the shoulder blade called the scapula. A layer of cartilage provides essential padding to the bones in this area and its two main joints. There are a number of issues that can cause shoulder pain. Let us get to know the six most common ones. 

1. Rotator Cuff Injury: This is the most common cause of shoulder pain and it occurs when the four muscles or the tendons are injured. These muscles and tendons usually control the movement of the arm. This injury can involve strains and tears which may also be caused by constant lifting of heavy objects. 
2. Rotator Cuff Tendonitis: This condition affects the tendons and muscles that help in moving the arm freely. This usually happens due to inflammation in the tendons. It is commonly experienced by patients who are actively involved in sports and other heavy physical pursuits in their line of work. 
3. Frozen Shoulder: This is a debilitating condition that restricts the free movement of the arm and is also known as adhesive capsulitis. When the shoulder tissues become too thick, it leads to the growth of scar tissue that hinders proper movement and causes pain. 
4. Osteoarthritis: Osteoarthritis is a condition that comes as part of aging bones that also become hollow and brittle over the passage of time, which leads to joint and bone pains in various parts of the body. It is a degenerative disease that is caused due to prolonged wear and tear as well as other factors including family history and sports injury.
5. Bursitis: This condition is known to affect the fluid filled sacs that lie in between the joints. These are known as bursae. When the bursae suffers from swelling, the effect usually shows up as pain in the joints. 
6. Tendon Sheath Inflammation: The fibrous tissue that connects the bones and the muscles is called a tendon. The presence of the tendon makes it possible to pursue activities like running, jumping, lifting, gripping and more. It is protected by a sheath known as synovium, which also lubricates the same. Any injury or tear to this sheath can cause shoulder pain.

Acute and persistent pain that does not abate and gets even worse should be treated with immediate medical intervention.