Shoulder Impingement - Rotator Cuff Syndrome

Shoulder impingement syndrome is also known as rotator cuff tendinitis.

The rotator cuff is comprised of four muscles and their tendons in the shoulder, connecting the upper arm and shoulder blade.  Rotator cuff syndrome refers to any injury, pain, or loss of function related to the muscles and tendons of the rotator cuff group.  The most common causes of shoulder dysfunction are a sports injury where there is low impact repetitive damage to the affected area or a sudden trauma to the shoulder.  There are three sources of injury that cause rotator cuff syndrome.  Tendinitis when the rotator cuff tendons are be irritated or damaged, bursitis when the lubricating sac in the shoulder called the bursa becomes inflamed and swells with more fluid causing pain, and impingement which occurs when the space between the acromion and rotator cuff narrows. The acromion “rubs against” or "impinges" on the tendon and the bursa, causing irritation and pain.

In some instances surgery may be necessary to create more space for the rotator cuff.

To accomplish this, the surgeon removes the inflamed portion of the bursa and may also remove part of the acromion for a “decompression.” These procedures can be performed using either an arthroscopic or open technique to restore range of motion, correct shoulder impingement and associated pain.

Our sports medicine specialists are available to evaluate patients with rotator cuff syndrome or other orthopedic concerns.

Symptoms of rotator cuff tendinitis

• Local swelling and tenderness in the front of the shoulder
• Pain and stiffness when lifting your arm
• Pain when the arm is lowered from an elevated position
• Minor pain that is present both with activity and at rest
• Pain radiating from the front of the shoulder to the side of the arm
• Sudden pain with lifting and reaching movements
• Athletes in overhead sports may have pain when throwing or serving a tennis ball
• Pain at night
• Loss of range of motion
• Difficulty doing activities that place the arm behind the back

If allowed to progress, pain will increase, and there could be a loss of strength, and a reduction in the shoulder range of motion.

Treatment for shoulder impingement syndrome

Your physician will consider your age, activity level, general health and type of tear you have before deciding on the best treatment plan for you.

Conservative Treatment: In most cases, initial treatment is nonsurgical. Nonsurgical treatment options include:

• Rest
• Activity modification
• Strengthening exercises and physical therapy
• Non-steroidal anti-inflammatory medicine such as ibuprofen
• Steroid injections
• Regenerative medicine options such as stem cell injection therapy may also be considered.