Shoulder Impingement

• What is it?
  • Anatomical structures getting pinched between the top of the humerus and the undersurface of the acromion
  • Pinches rotator cuff, biceps tendon and bursa
• Who gets it?
  • Both men and women
  • All ages
  • Impingement can be acute or chronic
  • Acute
    • a fall is usuall involved
  • Chronic
    • Usually with over shoulder activity
    • Overuse e.g. tennis, swimming, work
• Symptoms
  • Pinching shoulder pain with over shoulder activity
  • Radiates down the arm
  • Can click
• Signs
  • Pain with elevation
  • Pain with resisted motion
• Investigations
  • XR to check for a spur
  • US to check the rotator cuff for a tear
  • MRI if its not settling
• Treatment
  • NSAIDS
  • Physio
    • Cuff releases
    • Scapular control
    • Cuff strength
  • Corticosteroid injection
  • Keyhole surgery
• Prognosis
  • Most people get better without injections or surgery

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