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Impingement syndrome, often known by the broader term swimmer's shoulder, is a relatively common cause of shoulder pain in people who lead active lives, becoming even more common with age. In many cases, shoulder impingement can be treated with nonsurgical conservative options, but in more complex cases or when damage to the joint structures is more severe, shoulder surgery may be needed to repair damage and restore normal, pain-free movement and function in the shoulder.

What is impingement syndrome?

The shoulder joint has a unique anatomical structure where the muscles and other soft and fibrous connective tissues are located beneath and between the bones that comprise the joint rather than surrounding the bones. Specifically, the rotator cuff, a collection of muscles and tendons that supports normal movement and function of the joint, is located between the upper arm bone (the humerus) and the acromion bone at the top of the shoulder. When the rotator cuff is injured or irritated, it becomes inflamed and swollen. In other joints, the swelling can be accommodated by the expansion of the skin surrounding the muscles and tendons. But in the shoulder, these tissues are sandwiched between bones, and even simple movements can cause painful tissue compression and decreased blood flow in the tiny vessels that supply the tendons and other tissues.

Over time, the tendons weaken and tear, and swelling and inflammation cause chronic pain that can interfere with sleep and other daily. In some cases, impingement injuries can be associated with rotator cuff tears, or tears may develop when impingement issues are not promptly treated.

Impingement syndrome is more common among athletes who use their shoulders for repetitive motions or weight-bearing activities, including people who play baseball or tennis and avid swimmers. People who do a lot of overhead activities in their occupations are also more likely to develop impingement syndrome, and the condition becomes much more common with age.

What are the symptoms of Swimmer's Shoulder?

Shoulder impingement causes pain when you extend your arms over your head or reach behind your back, along with a feeling of weakness in the shoulder. Your shoulder joint may feel stiff and there may be some swelling or tenderness in the area when it's touched. Painful symptoms tend to persist even when the arm is at rest, especially if you sleep on the side of the injured shoulder. Without treatment, these symptoms will become worse, and eventually, you may notice a loss of strength in your arm and the biceps tendon may become damaged as well.

How is a shoulder impingement diagnosed and treated?

Diagnosis starts with a comprehensive exam of your shoulder and a review of your medical history and your symptoms. X-rays or MRIs can help confirm the diagnosis of impingement and rule out other conditions that can cause similar symptoms. Once the diagnosis is confirmed, treatment typically begins with conservative options like nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, ice packs and physical therapy. If these approaches don't provide relief within a few weeks or if damage to the rotator cuff or other structures is more severe, surgery may be recommended to expand the space around the joint, preventing compression and impingement of the rotator cuff.

In most cases, shoulder surgery can be completed using minimally-invasive arthroscopic techniques that rely on very small incisions, called shoulder arthroscopy. During the surgery, other issues like arthritis or bone spurs also may be addressed to improve overall function and movement in the shoulder joint. Once surgery is complete, you'll undergo a period of physical therapy to restore strength and mobility in your shoulder. Complete recovery can take about a year.

Schedule an evaluation today.

Shoulder impingement may begin with relatively mild symptoms, but without treatment, far more extensive damage can occur, both in the shoulder and in the upper arm. Don't let shoulder pain interfere with your life. Call Dr. Van Thiel with OrthoIllinois at to schedule a consultation and evaluation today, and learn how we can help you get back to the activities you love.

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