Subacromial impingement / Rotator cuff impingement
What is it?
Rotator cuff impingement occurs when there is pinching of the supraspinatus tendon between the greater tuberosity and the overlying subacromium. Patients typically have pain on the outside of their shoulder which is made worse by lifting the arm to side. Patients often find it uncomfortable to lie on that side. It is very common and typically affects individuals between the ages of 30 and 60.
What is it?
Rotator cuff impingement occurs when there is pinching of the supraspinatus tendon between the greater tuberosity and the overlying subacromium. Patients typically have pain on the outside of their shoulder which is made worse by lifting the arm to side. Patients often find it uncomfortable to lie on that side. It is very common and typically affects individuals between the ages of 30 and 60.
What causes it?
This can be caused by a number of problems including tendinopathy (wear and tear in the tendon), tears in the rotator cuff, calcium deposits, weakness in the rotator cuff muscles and bony spurs.
What happens if you do nothing?
Studies suggest that some patients will improve spontaneously with the passage of time, but persistent symptoms are common.
What happens if you do nothing?
Studies suggest that some patients will improve spontaneously with the passage of time, but persistent symptoms are common.
What treatments are there?
Avoiding activities which provoke the symptoms and taking anti-inflammatory medication can often improve symptoms. There is evidence that patients can improve with self-directed physiotherapy for this condition and there is an exercise programme designed for this from the British Elbow and Shoulder Society https://www.bess.org.uk/index.php/public-area/shpi-videos. For patients who fail to improve using with these exercises, more formal physiotherapy is often beneficial as well as steroid injections into the subacromial space. A small percentage of patients with persistent symptoms may benefit from keyhole operation called a subacromial decompression which makes ‘more space’ for the tendons. There are many studies supporting the role of subacromial decompression although some studies highlight we may not know the exact mechanism of action of the surgery. https://www.bess.org.uk/index.php/patients/csaw-statement