Shoulder impingement syndrome & acromioclavicular joint arthritis

Shoulder impingement syndrome & acromioclavicular joint arthritis

Shoulder impingement is a common cause of pain in the shoulder, making some of the most simple tasks a painful burden. From footballers and rugby players to the average person, shoulder impingement can affect anyone, though the causes can vary.

Our shoulder surgeons at Schoen Clinic London have many years of experience in treating all aspects of shoulder impingement, from rotator cuff tendonitis to acromioclavicular joint arthritis. Whatever is causing your shoulder condition, you are in the best hands with us.

How does shoulder impingement syndrome occur?

The shoulder is a very complex structure made up of several joints, tendons and muscles all working together to give you a range of motion and functionality. Due to the complexity of the shoulder there are many structures within it which are vulnerable to injury. The subacromial area lies between the top of the arm bone (humerus) and a bony prominence on the shoulder blade (acromion). The coracoacromial ligament completes the arch. A muscle and fluid filled cushion (bursa) lie between the arm bone and acromion. With certain movements and positions these structures can become pinched and inflamed, causing irritation or pain. This is what we call impingement.

Shoulder impingement syndrome symptoms

There are a number of symptoms which could be warning signs of shoulder impingement syndrome. These may only be mild during the earlier stages of the condition, but can gradually get worse as the problem progresses further.

  • Pain during rest periods and activity
  • Stiffness when lifting your arm
  • Sports involving overhead actions may become difficult
  • Loss of strength and range of motion
  • Night pain
  • Local swelling and tenderness

What causes shoulder impingement syndrome?

The pain that you have been experiencing is caused by the pinching of the structures in your shoulder and is typically felt on movements such as reaching and putting your arm into a jacket sleeve. Most of the time a dysfunction of the rotator cuff muscles, either due to wear and tear of the tendons, or to a muscular imbalance, might be responsible for the conflict between the bony structures and the tendons. Recovery of the muscular balance is crucial to improve this condition and for this reason physiotherapy plays a major role in conservative treatment or in the post-operative phase.

The acromioclavicular Joint (ACJ) is a small joint formed between the top of the shoulder blade (acromion) and the collarbone (clavicle). This joint can also be a frequent source of pain in the shoulder region, especially while performing movements at or above the level of the shoulder. Moving your arm across the chest at shoulder level to touch the opposite shoulder can produce significant discomfort if this joint is affected.

How we diagnose shoulder impingement syndrome?

Diagnosis can be reached through an accurate clinical examination supported by X-rays taken in two or three different views. Often an ultrasound scan can be useful to exclude any tendon damage.