Subacromial Impingement (aka "Bursitis")

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Introduction

  • Repetitive motion when you raise and lower your arm can cause your rotator cuff to rub up underneath the bone of the "point of your shoulder" (see video to the right).  

  • Over time, the rotator cuff tendon can get micro-tears in it and becomes irritated, swollen, and painful.  

  • This can eventually lead to a larger rotator cuff tear.  

  • An analogy is a rope that gets frayed over time and can eventually snap.

  • It is a gradual process that develops slowly over time.  It first starts with minor irritation of the rotator cuff tendon in which the body sends more blood (inflammation) to the area to help heal the area, and this is termed "tendonitis."  With proper rest, the problem can often be eliminated at this point.

Video Demonstrating How Impingement Happens

 
 

 Anatomy

  • There is a small sac between your rotator cuff and the point of your shoulder.  This sack is call a "bursa."  With repeated shoulder activity, the bursa gets pinched or squished over and over, and this results in the sack irritated, swollen, and inflammed.  This is termed "bursitis."

  • Although everyone is susceptible to shoulder impingement, the most common sufferers are people who make repeated overhead movements.  These include warehouse or shipping workers, painters and carpenters, swimmers and tennis players.  You are particularly vulnerable if you make weekend repairs that require a lot of shoulder force cince you don't normally use these muscles during the course of the week.  Your anatomy may also predispose you if the shape of your acromion (point of your shoulder) decreases the space for your rotator cuff to pass through (see below).  Lastly, poor posture is becoming a more frequent cause of bursitis because the shoulder does not work well with the shoulder blade is out of position. 

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Exam

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Imaging

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Treatment

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Complications

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Contact Information

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