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Home » Shoulder Impingement – causes & treatment

Shoulder Impingement – causes & treatment

Common Cause of Shoulder Pain

A shoulder impingement is seen to be one of the most common causes of injury pain, along with tendonitis and bursitis. When an individual flexes the arm, the rotator cuffs pass through the subacromial space which narrows during this movement. This subacromial space is situated beneath the acromion and above the glenohumeral joint. Within a healthy, pain-free shoulder, the rotator cuff’s tendons will not rub or catch against the acromion.

If you are suffering with a shoulder pain and want to talk to someone immediately, please contact Molly Haskins at the Norfolk Soft Tissue Therapy clinic. However, if you want to know more about this injury & the prescribed treatments please read on.

However, when suffering from a shoulder impingement, the tendons do rub, impinge or catch here. This primarily involves tendonitis (inflammation) of the supraspinatus rotator cuff tendon. This may be a result from a structural narrowing of the subacromial space. Consequently, this causes a pinching sensation, irritation and pain during shoulder flexion.

A patient being treated for a shoulder impingement by a qualified soft tissue therapist

Common causes

  • Overuse injury: This may cause the rotator cuff tendons to become inflamed, swollen or torn. This may occur in sports such as golf, gymnastics, racket sports, swimming etc. It may also be aggravated, depending on an individual’s profession that may use the shoulder daily for several hours at a time, such as gardening and painting.
  • The bursa, located between the tendon and acromion, may become inflamed and irritated. This could also be due to overuse of the shoulder, which can result in shoulder impingement. This may be painful, mostly a dull ache sensation and pain increases when injured site is touched, might be warm to the touch and slightly red in colour.
  • Spurs – which are bony growths that may sometimes develop with age, might grow on the acromion.
  • Structural issue: The acromion may not be flat, as it should. It may in this case be hooked or curved, causing an impingement.

What is a bursa?

A bursa has a fluid filled sac like resemblance, this fluid is composed of synovial fluid which provides bursae with sufficient lubricant for shock absorption. It is also lined with a synovial membrane, which encloses the sac, also, this membrane secretes the synovial fluid that is contained in each bursa. The membrane of a bursa is semi-permeable which allows for some materials to flow through; however, when an injury occurs here it may fill with blood or white blood cells. It is located both between the bony prominences of the body and soft tissues such as ligaments, tendons, and muscles; it also surrounds the joint itself.

An example of this is knee bursae as between there is an infrapatellar/ suprapatellar and prepatellar bursa present around the patella, similar to the bursa at the shoulder; as well as fat pads which have a similar function to bursae. The purpose of bursae is that they function as a cushion to absorb quite a high level of shock. It also reduces a great level of friction that may otherwise be created in moving structures within the body, so bursae allow these structures to glide smoothly as a joint is in motion. Bursitis is when the fluid filled sac becomes inflamed. This can affect any joint, but most commonly affects the most mobile joints, the elbows, hips, knees and shoulders.

A shoulder impingement should improve within a few weeks. If it does not then, a therapist would recommend that you seek medical advice from a general practitioner. If it does not improve and is seen to be a structural issue it may require subacromial decompression surgery, however this would not be a preferred option and may not help as much as intended.  Steroid injections are also an option, however this will only ease pain for a few weeks, before having to get this done again.

A patient being treated in the SOft Tissue Therapy clinic for a should injury

Therefore, the following is advised by a soft tissue therapist: Rest is key for recovery, therefore avoid heavy lifting, but movement is also important so that it doesn’t weaken or become stiff. Ice may also help the pain and inflammatory response; ice for 10-20 minutes, making sure that a towel is used between the skin and ice itself. This can be done a few times a day.

After pain has eased and swelling has improved, a soft tissue therapy treatment plan can aid with providing strengthening exercises, stretches and relieving the surrounding soft tissues from any build-up of scar tissue and help to loosen and realign fibres. They can also help to restore elasticity in the muscles that may have been in a protective holding pattern, in addition to unwanted tension. 

Disclaimer information

*This should not be taken as medical advice and you should still contact your GP/hospital if you suspect a serious injury. *