Rotator Cuff Impingement

What is a rotator cuff impingement?

A rotator cuff impingement is a shoulder injury that affects the muscles and tendons you use to lift and move your arms.

Your rotator cuff is the name for the group of muscles and tendons between your arm (humerus) and the tip of the outer edge of your shoulder blade (acromion).

You use these muscles and tendons when you raise your arm over your head and rotate your arm to and from your body.

If one of these tendons get injured, they swell and the top of your shoulder joint pinches them (hence the name impingement), restricting blood flow.

The swelling causes the tendon to rub against the acromion, narrowing the space more and causing the tendon to fray.

Other names for rotator cuff impingement include:

• Subacromial impingement syndrome
• Subacromial bursitis
• Pinched rotator cuff
• Rotator cuff tendinitis or tendinopathy.

What are the symptoms of rotator cuff impingement?

If you have a rotator cuff impingement, you’ll notice the following symptoms:

• Pain in your shoulder – this pain will get worse when you move your arms over your head, behind your back or twist your shoulder
• Arm weakness – your arm may also feel stiff.

You will most likely notice pain when you’re lying on the affected shoulder – as well as pain at night, which can make it difficult to sleep.

What causes rotator cuff impingements?

Rotator cuff impingement can be caused by:

• Injuries – like falling on your shoulder or an outstretched arm
• Activities that involve overhead rotational motions – including swimming, tennis, painting and window washing
• General wear and tear – as you age, you are more likely to experience rotator cuff injuries.

If your rotator cuff impingement is due to an injury, the pain will occur suddenly.

If it’s due to general wear and tear as you age, though, the pain will come on gradually.

Because rotator cuff impingement has similar signs and symptoms to other types of shoulder injuries it’s important to get a proper diagnosis and treatment.

Many shoulder injuries can occur in combination with other types of injuries. A severe rotator cuff impingement can lead to a torn biceps muscle tendon.

How do I know if I have a rotator cuff impingement?

Dr Chia will take a detailed history and perform a physical exam. He will ask you about your activities, general health and any injuries that may have happened before your symptoms started. He will examine your shoulder to identify the location of the pain and any issues with strength and motion.

You may need an X-ray, ultrasound or magnetic resonance imaging (MRI) scan to determine the cause of your shoulder injury. These scans can rule out other causes and identify any other issues.

What are the treatment options for rotator cuff impingements?

There are both surgical and non-surgical treatment options for rotator cuff impingements.

Non-surgical treatments include:

• Rest
• Activity modification
• Ice
• Medications for pain relief
• Steroid injections
• Physiotherapy exercises.

Dr Chia will develop a personalised treatment plan incorporating these treatments so you can manage your injury safely at home.

Many people are able to improve their range of motion and reduce shoulder pain after a few weeks or months.

Surgery

If your symptoms don’t improve after trying the non-surgical treatment options, you may need surgery. Surgery can help to improve your pain and increase your range of motion in your shoulder.

The surgical technique for rotator cuff impingement is called subacromial decompression (SAD). During the surgery, Dr Chia will remove part of the acromion which helps to create more space for the rotator cuff. Dr Chia uses keyhole surgery (minimally invasive) which involves a series of small cuts rather than one large cut.

In many cases, you can return home straight after your surgery. You will need to wear a sling for a few days. Most people regain full range of motion after a few weeks.

If you need surgery, Dr Chia will explain the surgery and recovery process in detail.