Impingement (jamming in the shoulder)
Why do you get impingement?
Muscular imbalance: This can be due to an imbalance in a set of muscles called the rotator cuff. Its job is to keep the upper arm centered in the shoulder joint. If the coordination and strength between these four muscles is not optimal, a pinching can occur under a bone from the shoulder blade called the acromion. This can occur during repetitive work with the arm in front of the body, for example when painting a lot or when working at the cash register in a store. It can also occur during various sports such as tennis, swimming and weight training.
Trauma to the shoulder: For example, when you reach for your arm, you can accidentally press these tendons against the acromion, causing damage and thickening in one or more of the rotator cuff tendons. The sac in the area, the subacromial bursa, can also swell. This can cause tightness under the acromion when you lift your arm, causing pain.
Tight anatomically
We may have a less advantageously shaped shoulder, which makes it easier for the rotator cuff tendons to become cramped between the acromion and the acromion. Over the years, we may also develop bone spurs on the underside of the acromion and/or the underside of the ac joint, which can cause pinching in the area, resulting in pain. The subacromial bursa can swell for a long time (chronic bursitis) and contribute to pain and stiffness in the shoulder.
Shoulder joint hypermobility (laxity): Hypermobility in the shoulder joint capsule and surrounding ligaments can be genetic or it can be caused by the sport you play. Swimmers, tennis players and gymnasts are examples of athletes who are affected. The instability in the shoulder makes it easier for the rotator cuff tendons to get pinched under the acromion.
Symptoms of impingement
Pain on the outside, front of the shoulder/upper arm during arm activity and often when lifting the arm out to the side or forward. It may hurt to lie on the affected shoulder. Weakness and stiffness in the shoulder are other symptoms. Unless the injury is acute, it is not that common to have dull pain at rest.
Treatment of impingement
Often a combination of manual treatment and exercise rehabilitation is used to restore function in the shoulder joint. In some cases, shock wave therapy may be a good alternative. We resolve most cases with treatment and exercise. If this does not help, it is possible to examine the shoulder with ultrasound diagnostics to see if more information can be obtained about what is causing the problem. If we consider it appropriate, we can give an ultrasound-guided cortisone injection. The next step if there is no improvement is to refer to a doctor for a decision on possible surgery.
