Shoulder impingement is a common cause of shoulder pain and is often caused by an inflamed tendon rubbing against or catching on part of the shoulder blade. At The London Clinic, we offer first-class treatment options for shoulder impingement in our state-of-the-art facilities.
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Shoulder impingement consultation at The London Clinic
Shoulder impingement occurs when the space narrows between your rotator cuff (a group of muscles and tendons in your shoulder) and your acromion (the top part of your shoulder blade). In between the rotator cuff and the acromion lies the bursa, which often gets inflamed first.
When you lift your arm, the rotator cuff rubs or catches on the acromion, causing pain.
Typically, the space between the rotator cuff and acromion narrows because tendons have become inflamed due to bony growth or some injury to the rotator cuff tendon. Â
Treatment for shoulder impingement often involves rest and simple shoulder exercises to help ease pain and improve your range of movement. Anti-inflammatories and physiotherapy can also be suggested initially as a treatment.
If your shoulder impingement is severe and long-standing, it can lead to a rotator cuff tear. Sometimes the treatment may involve arthroscopic (keyhole) surgery if this is the case.
At The London Clinic, we’ve a team of world-class consultants who are experts at diagnosing and treating all types of shoulder impingement.
They’re assisted by an expert multidisciplinary team that will support you from your first consultation, during diagnostic procedures and throughout your treatment. Â
As one of our patients, you’ll receive exceptional personal care the whole time you’re with us.
With everything you need under one roof, from physiotherapy to post-care, we look after the details so you can focus on getting back to the life you love.
What is shoulder impingement?
The rotator cuff tendon is a strong band-like tissue that connects the muscles around your shoulder joint to the top of your arm.
It passes throw a narrow space at the top of your shoulder called the subacromial space.
At the top of the subacromial space sits the top outer edge of your shoulder blade (known as the acromion).
Shoulder impingement happens when you lift your arm and your rotator cuff rubs (impinges on) or catches on the acromion, causing you pain.
What causes shoulder impingement?
Most cases of shoulder impingement are caused by overuse of the shoulder, which is why it affects a lot of sportspeople. Overhead activities, such as decorating and painting, for example, can also lead to irritation of the bursa, which can then lead to shoulder impingement.
Continuous impingement which is left untreated can lead to thickening of the acromion bone and injury to the rotator cuff, causing rotator cuff tears.
Other reasons why you may be affected by shoulder impingement include:
- The fluid-filled sac (bursa) found between your rotator cuff tendon and acromion becomes irritated and inflamed (a condition known as bursitis). This can be caused by injury or overuse of the shoulder.
- Your acromion is curved or hooked, rather than flat. This tends to be something you are born with.
- You have bony growths (spurs) on your acromion. These tend to develop over a long period of time, which means your age could have an impact, however this can happen at any time.
What are the symptoms of shoulder impingement?
Shoulder impingement usually comes on gradually as it develops over weeks and months. However, you may also experience an acute, severe, painful episode as an indication of shoulder impingement.
Common symptoms of shoulder impingement include:
- Pain when you lift your arm, and especially when you lift it above your head Â
- Pain and tenderness in the front of your shoulder
- Pain that moves from the front of your shoulder to the side of your arm
- Pain when lying on the side that’s affected
- Pain felt on the middle of the outer arm area
- Pain or achiness at night, which may stop you from sleeping
- Pain when reaching behind your back
- Weakness in your shoulder or arm (when lifting)
How is shoulder impingement diagnosed?
Your doctor will first discuss your symptoms, medical history, previous injuries and exercise habits.
They’ll also carry out a physical examination while asking you to perform a series of motions using your shoulder.
This can help to rule out other conditions.
To get a better look at your shoulder and diagnose your condition, your doctor may also recommend that you undergo an imaging test, such as an ultrasound, 3T MRI or X-ray.
We offer fast access to these tests without delay and get the results back to you quickly, so you can get the answers you need to make the best decisions about your treatment.
What are the treatments for shoulder impingement?
The London Clinic is a renowned private provider of orthopaedic care. Our priority is to provide you with the very best and latest treatments, as well as outstanding personalised care.
Our orthopaedic consultants will develop a treatment plan based around you and your needs.
You’ll have access to a multidisciplinary team including physiotherapists to ensure you exercise safely to improve your symptoms.
Depending on how severe your shoulder impingement is, your consultant may recommend one or more of the following treatments:
FAQs
Things you can do for yourself that may help reduce pain and restore shoulder function include:
- Resting and avoiding activities that involve you repeatedly lifting your arm above your head, such as swimming or tennis.
- Not resting your arm completely, for example, in a sling. This will prevent your shoulder from becoming weak or stiff.
- Applying an ice pack or similar to your shoulder for 10 to 15 minutes at a time and a few times a day. This will help to reduce pain and swelling.
- Taking anti-inflammatory painkillers (such as ibuprofen) or paracetamol.
Your consultant may refer you to a physiotherapist at The London Clinic who specialises in shoulder injuries.They will develop a personalised series of exercises for you to improve your shoulder posture and strengthen your muscles.This will help to ease your pain and improve your range of movement.You may need to do your exercises with your physiotherapist at first, but in time you should be able to do them at home by yourself. Typically, with the right care and shoulder exercises, an impinging shoulder often improves in a few weeks or months.
If rest, exercises and anti-inflammatory painkillers don’t ease your pain, your consultant may recommend you have steroid injections (cortisone).You may find this treatment helps your pain completely and no further treatment is required. In other instances, it can reduce the pain for only a few weeks at a time and several courses may be offered alongside exercises. If the steroid injections do not work for you, your consultant will discuss other options.
If other treatments don’t work, your consultant may recommend that you have a keyhole operation called a subacromial depression, with or without a rotator cuff repair.The aim of this surgery is to widen the space around the rotator cuff tendon, so it doesn’t rub or catch on your acromion (outer edge of your shoulder blade).This is usually done with minimally invasive arthroscopic surgery (keyhole surgery). During this procedure, if the rotator cuff is found to be torn as well as, it may be repaired at the same time, of which your consultant can discuss with you prior to the surgery.This type of keyhole surgery involves small surgical instruments being passed through small cuts in your shoulder.Most people can go home the day after their shoulder arthroscopy, some even the same day, however your consultant will discuss this with you. The London Clinic also offers an extensive rehabilitation programme to help you get the best results from your surgery.
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