Shoulder Impingement

What is shoulder impingement?
The shoulder is made up of several joints, tendons, and muscles that allow great range of motion in the shoulder. Because so many different structures make up the shoulder joint, it is vulnerable to various injuries. Common shoulder conditions include multidirectional instability, subacromial bursitis, calcific tendinitis, overuse tendinopathy, rotator cuff tears, and frozen shoulder. All of these conditions cause painful and/or limited range of motion and result in shoulder impingement. This is a clinical syndrome that occurs when the tendons of the rotator cuff muscles, the bursa, or the glenohumeral joint ligaments become irritated, inflamed, or overused.

Management
It is important to assess the underlying cause of shoulder impingement to achieve optimal results and prevent future injuries. A diagnostic ultrasound may be performed in clinic to assess the rotator cuff and shoulder joint and evaluate for any tears, lesions, or bursitis. Treatment is based on the severity of the patient’s symptoms and typically includes ice, anti-inflammatory medication, activity modification, and physical therapy. In patients with persisting symptoms despite conservative treatment, corticosteroid injections can be performed under ultrasound guidance to reduce pain and inflammation, enabling patients to maximize physical therapy. If pain continues to persist, obtaining an MRI may be helpful to rule out soft tissue pathology, such as a labral tear or a SLAP lesion.