Shoulder Impingment/Bursitis

Terms: Rotator Cuff - Supraspinatus, Infraspinatus, Teres Minor & Subscapularis 

           Acromion- Extension or tip of shoulder blade.

           Bursa- Fluid-filled sac that acts as a lubricant for smooth joint movement.  Think WD40 for the joint. 

This particular injury develops if either of the following occur : the four muscles of the rotator cuff  (which act to depress the humeral head) are injured, the patient was born with a type II or III downward hook of the acromion, development of a bone spur under the acromion process generally with age. The rotator cuff injury or bony abnormalities wind up taking valuable space typically reserved for pain-free shoulder movement between the head of the humerous and the acromion. The result is rubbing or pinching on the tendons and the sub-acromial bursa between the the tendons and acromion. 

This injury is not reserved for throwing or overhead athletes although it is a typical culprit. It is fact very common in middle-age individuals. as bone spurs tend to develop with age the rotator cuff muscles become more suceptible to impingment.

Steps to treat shoulder impingement/bursitis or tendinitis involve the initial steps of using ice therapy , modalities and anti-inflammatory medications to reduce pain and swelling. Once swelling and pain are under control, physical therapy goes to work to regain lost range of motion and strength to the shoulder. In more difficult cases arthroscopic shoulder surgery (Subacromial Decompression) can be performed to clean up the spur and create more joint space. This increase space allows for improved movement within normal limits and less irritation resulting in a reduction of future inflammation and pain with activity.