Shoulder Impingement - Ipswich Hospital

Department of Trauma and OrthopaedicsTel: 01473 702384Shoulder ImpingementInformation for PatientsWhat is the problem?The shoulder joint is a ball-and-socket typejoint. The ball is held in the socket by a sheetof tendons. Above the tendons is a narrowspace below an arch made up of a bone (theacromion) and a ligament. The ball and tendonshave to move under the arch. As the arm islifted away from the body the space narrows.If the tendon has worn or the arch enlarges,narrowing the space then the tendon canbe pinched (impingement). Other causes canbe an alteration in shoulder posture furthernarrowing the space or calcium deposits in thetendon.acromion attached toshoulder bladespur ofbonearmboneligamentsub-acromialspaceThe diagnosis is made from your history and the examination. An x-ray is usually performed.A scan may be indicated if a tendon tear is suspected.bursaacromiontendonWhen the armis lifted awayfrom the body,the space forthe tendon isreduced.acromiontendonarm bonearm boneSub-acromial space with arm by sideSub-acromial space witharm stretched outWhat are the treatment options?Usually cases of shoulder impingement will settle if activities are modified and physiotherapyexercises are performed. An injection may help. Surgery is rarely needed.DMI ref: 4623-07.indd(RP)What can I do to help my shoulder?Activities that produce pain should be avoided. These activities will generally make the tendonswelling worse. Typically these are overhead activities or working with the arm away from yourside. Try working at a lower level or using steps if the job is high up. Keep your elbow tucked inby your side.Pain relief medication is sometimes helpful. If you have no allergy to it and no history ofindigestion or stomach ulcer you may be able to try a short course of anti-inflammatorymedication such as ibuprofen.Ô

ExercisesYou will usually be referred to the physiotherapy department forinstruction on exercises. It should be possible to find a set of exercisesthat you can work on without causing pain. You will be asked towork on your posture including back and shoulder blade exercises aswell as the shoulder itself.The painful shoulder will usually be held lower than the other. Asimple shoulder blade exercise to correct this is to hold the armsrelaxed and then square the shoulders. Stand in front of a mirror andpull your shoulder blade back and up to match the other side. Holdthe position for 10 seconds. Repeat the exercise ten times. Work onthis exercise about four times a day. Try to maintain a good posturethroughout the day.If you have any queries or concerns about your treatment orrecovery, please contact the Orthopaedic Department on 01473702384.Produced by:The Ipswich Hospital NHS TrustHeath Road, Ipswich, Suffolk IP4 5PDHospital switchboard: 01473 712233www.ipswichhospital.nhs.ukIssue 1: March 2008© The Ipswich Hospital NHS Trust, 2008. All rights reserved. Not to be reproducedin whole, or in part, without the permission of the copyright owner.