Shoulder Impingement

What is shoulder impingement?

Shoulder impingement is also called swimmer’s shoulder or tennis shoulder. For most patients and athletes experiencing persistent shoulder pain, an Austin shoulder impingement doctor can identify the underlying cause and recommend effective treatment. This comprehensive guide explores common symptoms, risk factors, diagnostic methods, and medical solutions for shoulder impingement.

Your shoulder joint, the most flexible and complex ball-and-socket joint, is made up of various muscles, soft tissues, ligaments, and tendons that help provide shoulder mobility. The rotator cuff is a group of rotator cuff muscles and rotator cuff tendons, including the bicep tendon, that cover the head of your upper arm bone. The head of your humerus rests inside a hollow groove in the shoulder blade. Above the shoulder bones is a bony protrusion known as the acromion, part of the acromioclavicular joint, which helps to protect the rotator cuff muscles and reduce inflammation in this flexible joint.

If a rotator cuff injury, like a rotator cuff impingement or a partial tear, is present, or the rotator cuff becomes swollen or irritated due to chronic inflammation, it can cause the tendons to become pinched between the upper arm bone and acromion. This pinching of the rotator cuff tendons between bones is known as shoulder impingement syndrome, also commonly referred to as subacromial impingement syndrome or impingement syndrome, which can cause shoulder pain, discomfort, and a limited range of motion in the most flexible joint of the body.

Left untreated, shoulder impingement pain may lead to internal impingement, bursitis in the subacromial bursa, or other shoulder pathology, potentially resulting in shoulder instability or the need for shoulder surgery performed by a board-certified Austin shoulder impingement specialist or a sports medicine physician.

What causes shoulder impingement syndrome?

Naturally, whenever you lift your arm overhead to shoulder level, the subacromial space between your arm bone and acromion becomes constricted. This can cause the tendons and soft tissue structures located between your arm and acromion to become pinched and irritated, leading to shoulder pain and potentially bursitis in the subacromial bursa.

Overexertion or overuse is one of the most obvious causes of developing shoulder impingement. Because of this, sports and other activities or occupations that require frequent or forceful overhead movements, including those involving the knee in athletic activities, increase shoulder impingement risk factors. Young athletes and swimmers often develop swimmer’s shoulder, a form of external impingement, which may require conservative treatment such as physical therapy or R.I.C.E (rest, ice, compression, and elevation), or, in severe pain cases, surgical techniques such as shoulder arthroscopy using general anesthesia or rotator cuff repair to reduce pain in the shoulder and restore full range of motion.

Other causes for shoulder impingement may include:

• Being born with a narrow subacromial space in the shoulder joint
• Certain degenerative changes or bone spurs related to arthritis that create less space for tendons
• Engaging in activities that require routine shoulder use, which may lead to overuse injury
• Overtraining or poor training habits that contribute to shoulder injury
• Having an unstable or affected side shoulder, which can increase the risk of impingement
• Sudden trauma to the shoulder or coracoid process irritation causing inflammation in the shoulder joint
• Lifting or moving heavy boxes that cause pain and strain on the shoulder joint
• Poor posture or abnormal shoulder anatomy affecting the biomechanics of the shoulder joint

What are the symptoms of shoulder impingement?

Symptoms of shoulder impingement may include:

• Impaired mobility e.g., having difficulties reaching behind your back, which can be caused by rotator cuff tears, often leading to shoulder pain in older adults
• Shoulder pain with overhead movements or when lifting your arms, sometimes resulting from bursitis that causes significant shoulder pain and limited motion
• Weakness of the shoulder area, commonly due to injuries or overuse affecting the rotator cuff muscles and tendons

How is shoulder impingement diagnosed in your Austin, TX practice?

If you are experiencing any of the above symptoms or believe you have a shoulder impingement or frozen shoulder, an evaluation by an experienced shoulder impingement specialist in Austin, TX can help determine the cause of your symptoms.

To help diagnose shoulder impingement, an Austin shoulder impingement surgeon will begin by going over your medical history and symptoms, including whether you are experiencing shoulder pain or instability in the affected shoulder. Next, your Austin shoulder impingement doctor  will perform various physical examinations to help assess your mobility, strength, and degree of pain, often using the latest technology for precise evaluation.

To ensure that your symptoms are not the result of similar medical conditions such as rotator cuff tears or shoulder instability, your doctor may also examine your neck for signs of a pinched nerve or other conditions. Your doctor may also need to perform additional testing for further diagnosis. Additional testing may include X-rays, magnetic resonance imaging (MRI), or other imaging to evaluate the joint and soft tissues.

This comprehensive approach helps develop a personalized treatment plan that may include conservative care with anti-inflammatory medications or physical therapy before recommending shoulder surgery. Understanding the complex anatomy of the shoulder is essential for successful treatment.

How is shoulder impingement treated: Conservative treatment or surgery?

If you are suffering from shoulder impingement and are seeking pain relief, there are surgical and nonsurgical treatment options available. Based on various factors, such as your activity level and health, treatment will vary, and your Austin shoulder impingement surgeon may recommend surgery only when necessary.

Here at our practice, whenever possible, we aim to first recommend nonsurgical treatments to help restore mobility, alleviate posterior shoulder pain, and prevent the progression of damage. Nonsurgical treatment options may include:

• Resting and avoiding overhead activities to reduce strain on the shoulder joint and allow healing.
• Avoiding activities that induce shoulder pain to prevent further irritation and inflammation.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) to bring down swelling and pain, often combined with over-the-counter medications for effective pain management.
• Physical therapy and exercise to improve shoulder strength and mobility, typically lasting 3 to 6 months and tailored to support full recovery.
• Steroid injections to help relieve pain and reduce inflammation in the joint.

When medications and treatment from a physical therapist are ineffective, we specialize in and offer shoulder impingement surgery options such as arthroscopy and open shoulder surgery (arthroscopy, which uses small incisions and a camera, and traditional open surgery to help effectively treat shoulder impingement). Platelet-rich plasma therapy may also be used to help promote natural healing, alleviate pain, and enhance recovery time, which varies depending on the procedure performed and complexity of the injury.

Most patients begin physical therapy within 3 to 6 weeks post-surgery, with pain and swelling being normal in the first two weeks. Recovery times vary, but many patients can return to normal use and daily activities within 3 to 6 months, although full recovery may take 6 to 12 months for more complex injuries and cases.

This comprehensive approach by a qualified Austin shoulder impingement doctor like M. Tyrrell Burrus, MD ensures optimal outcomes for patients in the Austin area.

Schedule a Consultation With a Shoulder Impingement Doctor Austin

If you are experiencing symptoms of shoulder impingement or other shoulder issues, a consultation with an Austin shoulder impingement specialist may be the first step towards diagnosis, treatment, and recovery. M. Tyrrell Burrus, MD, is an experienced fellowship-trained doctor in Austin, Texas, who is dedicated to providing high-quality, specialized holistic care for shoulder conditions, including shoulder impingement, arthritis, labrum tears, rotator cuff tears, SLAP tears, adult reconstructive surgery, and shoulder replacement surgery using artificial components for damaged joints. Call (512) 324-9170 or fill out the form on this page to schedule an appointment.