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What is Shoulder Impingement Syndrome?

ShoulderjointShoulder Impingement Syndrome is a result of the compression of muscles and tendons in the shoulder region leading to swelling and pain in the shoulder. It is also known as Pi  tcher’s Shoulder or Swimmer’s Shoulder or Tennis Shoulder. This syndrome usually affects athletes and aging adults and generally occurs in combination with rotator cuff tendinitis and shoulder bursitis.

Shoulder Anatomy:

Let’s get a brief insight into the anatomy of the shoulder before we begin to understand Pitcher’s Shoulder.

Unlike many bones in the body which are surrounded by muscles, shoulder muscles are surrounded by bones. These muscles are known as rotator cuff muscles.

Shoulder comprises of 3 bones: shoulder blade or scapula, collarbone or clavicle and upper arm bone or humerus. The shoulder joint is a classic example of a ball and socket joint where the rotator cuff fits the top rounded portion of your upper arm bone into the socket shaped shoulder blade.

A lubricating sac known as bursa is present between the rotator cuff and the top bone of your shoulder called as acromion. This sac allows the gliding action of the tendons in rotator cuff during the movement of arm.

What is Shoulder Impingement Syndrome?

As mentioned earlier, it occurs in combination with 2 other conditions.

Bursitis – Increased fluid levels inside bursa may lead to swelling and inflammation which in turn may cause pain.

Tendinitis – Irritation or damage of rotator cuff tendons.

Impingement – This occurs when the acromion rubs against the rotator tendon and the bursa leading to pain and irritation. Impingement usually occurs when the space between the rotator cuff and acromion narrows when the arm is raised to shoulder height.

Causes of Shoulder Impingement Syndrome:

Athletes, laborers and construction workers who perform their duties with raised hands most of the time are at higher risk of getting affected by Tennis Shoulder. Activities which cause pain in the rotator cuff or shoulder pain include: baseball, swimming, tennis, paper hanging, painting, construction etc.

The rotator cuff muscle reacts to an injury caused to it by swelling, just like an ankle reacts to a sprain. But because of its anatomy, muscles surrounded by bones, the swelling triggers a chain of events.

Increasing pressure in the muscle leads to its compression and decreased blood flow in the capillaries or small blood vessels. Due to the diminished flow of blood, the muscle starts to fray just like a rope. The pain may be worsened by performing tasks that involve the lifting of arms to shoulder height or behind the back.

Symptoms of Shoulder Impingement Syndrome:

  • Tenderness and swelling of the shoulder.
  • Shoulder pain when lying on the affected shoulder.
  • Pain during arm movement.
  • Pain while performing overhead activities such as reaching for objects placed on shelves, brushing hair, buttoning etc.
  • Pain beginning at the front of the shoulder and reaching the side of the affected arm.
  • Sudden pain in the shoulder when lifting objects              .
  • Pain at night.
  • Gradual loss of motion and strength.

Diagnosis:

The first step in diagnosing Swimmer’s Shoulder is to get a shoulder physical examination done. X-rays can detect bone changes and bone spurs. Inflammation if any can be seen in an MRI.

Treatment for Shoulder Impingement Syndrome:

  • Rest the shoulder as much as you can by avoiding pain causing activities.
  • Non steroidal anti inflammatory drugs can relieve the pain temporarily.
  • Physical therapy involving stretches can be of help.
  • Injecting steroids such as cortisone into the bursa can relieve pain.

If these non-surgical techniques are not efficiently treating the pain, the next option to opt for is surgery.

  • Arthroscopy – In this technique, surgical instruments are inserted into the shoulder via punctured holes. The surgeon then examines the swollen shoulder through a fiberoptic scope that has been connected to a television camera. With the help of a video monitor, the doctor guides the instruments in removing soft tissue and bone.

Surgery – This involves treating the condition by making a small incision in the shoulder.

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