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An “impingement” of the shoulder refers to a medical condition wherein the connective tissues attached to the arm’s rotator cuff become compressed. This occurs in the space beneath the scapula and the shoulder blade, scientifically known as the “subacromial space.” Compression in this area can have several causes. It can occur naturally in cases where the bones involved have a curve or bend to them because of the individual’s growth. Overuse due to repetitive movements, such as swimming or pitching, along with injury-causing trauma can also contribute to impingement.

As the tendons become compressed and have less room to move, the resulting friction causes painful wear and tear. This can ultimately lead to tendinitis and, if left completely untreated, space can shrink further and increase the risk of a tear. Shoulder impingements cause pain both at rest and in motion, limit the range of motion one experiences, and may render you unable to move the affected arm whatsoever.

The two types of impingement syndrome

Impingements come in two varieties and can progress through several stages. Both the nature of impingement you experience and its progression is essential for understanding the right treatment options. In a primary impingement, the issue occurs due to the patient’s body structure. Growth over time leads to restrictions of the tendons’ free movement, ultimately leading to impingement. These problems have a gradual onset due to their nature. In the secondary type, overuse, primarily by young athletes, creates too much wear on the tendons and leads to this painful condition.

Common symptoms of shoulder impingement

How can you tell if you’re in the initial stages of an impingement? You may experience some or all the following symptoms:

  • A slow, creeping onset of pain in the shoulder (primary impingement).
  • Severe acute pain in the shoulder area (secondary impingement).
  • Reduced range of motion.
  • A sensation of “popping” when moving your arm.
  • Increasing pain when undertaking overhead activities.

If you experience any of these symptoms, consult with a healthcare professional. Delayed treatment can lead to the development of bone spurs and may limit options for treatment. In that vein, how do doctors approach impingement patients?

Treatment options

In the earliest stages, treatment for shoulder impingements focuses on proper pain management options, rest, and re-strengthening of the rotator cuff through physical therapy. Usually, NSAIDs or a pain-relieving injection can help to control the discomfort patients experience from this condition. Your doctor will conduct a thorough assessment of your arm’s function to determine the extent of the problem. X-rays may be useful in determining the type and severity of the impingement. However, when treated early on, restoration of full function is often achieved through entirely non-invasive means.

With that said, more advanced impingements, especially where the motion of the arm is more severely limited, may require surgical intervention if they do not respond to other treatments. For that reason, if you experience any of the symptoms of impingement, especially acute and severe pain, speak to your physician. Timely treatment can control this issue and provide faster relief.


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