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Shoulder Impingement

  • What is it?
    • Anatomical structures getting pinched between the top of the humerus and the undersurface of the acromion
    • Pinches rotator cuff, biceps tendon and bursa
  • Who gets it?
    • Both men and women
    • All ages
    • Impingement can be acute or chronic
    • Acute
      • a fall is usuall involved
    • Chronic
      • Usually with over shoulder activity
      • Overuse e.g. tennis, swimming, work
  • Symptoms
    • Pinching shoulder pain with over shoulder activity
    • Radiates down the arm
    • Can click
  • Signs
    • Pain with elevation
    • Pain with resisted motion
  • Investigations
    • XR to check for a spur
    • US to check the rotator cuff for a tear
    • MRI if its not settling
  • Treatment
    • NSAIDS
    • Physio
      • Cuff releases
      • Scapular control
      • Cuff strength
    • Corticosteroid injection
    • Keyhole surgery
  • Prognosis
    • Most people get better without injections or surgery

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