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Shoulder Impingement Syndrome
Answers to Questions about Shoulder Impingement Syndrome
What is Shoulder Impingement Syndrome?
What Causes Shoulder Impingement?
How Long Does Shoulder Impingement Syndrome Last?
How do I Heal a Shoulder Impingement?
What Can I do Now?
What is Shoulder Impingement Syndrome?
You Can Heal it With the Right Steps!
Shoulder Impingement Syndrome is a painful condition that can get in the way of life.
It is a unique type of Rotator Cuff Injury.
In fact, it is sometimes called Rotator Cuff Impingement.
The main difference between the two is that a Rotator Cuff Injury is usually a muscle strain while Shoulder Impingement Syndrome is more often a tendonitis or Bursitis issue.
If your doctor can identify a strain or tear in one of the muscles of the rotator cuff, they will likely say that it is a Rotator Cuff Tear.
If they cannot identify a specific torn or strained muscle, they will likely say it's impingement.
Impingement just means something is getting squeezed.
In your case there is a tendon that is getting squeezed by or rubbing against a bone causing irritation and swelling in your shoulder.
There is not a lot of space in the shoulder so, when tissues become irritated and inflamed, the rubbing against bones gets worse.
'Gets worse' means more swelling and more swelling means more abrasion, and that catch-22 situation is why they call it a 'syndrome'.
Once it starts, it makes itself worse until you get it under control.
A lot of sites on the web will say that it is 'a repetitive overuse injury that happens over time'.
That may be true, but there's probably more than just repetitive use that started it.
Often there was a specific incident that brings it on.
Not generally a fall or something traumatic of that nature.
That is more likely to cause a muscle strain.
Your Shoulder Impingement more likely started when you did a strenuous task repeatedly that your body wasn't used to.
Or, perhaps you are often in a position where your arm is held up near the end of the range or motion for long periods of time.
When one of these things happens, you can squeeze the tissues inside the shoulder in a way that they become irritated and inflamed.
Then, once you have the problem, it is easy to develop a cycle of reinjury and increasing irritation over time.
The impingement increases the inflammation; the Inflammation causes impingement and on it goes.
Taking steps to get out of this reinjury loop is the key to healing this condition.
You use your shoulder all the time so healing this injury can be a challenge.
Rest is the key factor in healing for most people.
There are proactive treatments you can use, but for most people, patience, rest and stopping any ongoing strain will usually be enough.
Anatomy of Shoulder Impingement Syndrome
The Key Parts of the Shoulder
In simple terms, Impingement in the shoulder is when the bursa is not protecting the tendons in your shoulder, and both are getting inflamed from rubbing against the Acromion Bone.
Your shoulder is very complex.
But a simple way to think about Shoulder impingement is to understand the rope, pillow and muscle analogy.
With shoulder impingement syndrome there are two key bones involved.
One bone is the 'Acromion' which you can think of as the end of your collar bone.
Underneath that bone is your 'humerus' bone which is just your arm bone where it goes into your shoulder socket.
There's a tendon (rope) attached to the top of your humerus/arm bone that the muscle uses to pull on your arm bone when you want to raise your arm.
The tendon/rope is attached to the arm bone at one end and to the shoulder muscles at the other end.
When the shoulder muscles pull the tendon/rope it moves and raises the arm.
Because the tendon runs between the bony part at the top of the shoulder and the bone at the top of the arm, a lot of motion can lead to a lot of wear-and-tear.
The good news is your body is built for this.
To reduce the wear and tear, your body has this neat little super slippery pillow between the tendon and your collar bone.
The slippery pillow protects the tendon so you can do repetitive motion over and over again without damaging the tendon
The pillow is called a 'bursa'.
It has a slippery surface, it's filled with fluid to make the pillow squishy, and it self lubricates.
A bursa is pretty impressive.
The pillow sits between the bones and the rope/tendon and keeps the bones from rubbing against the tendon.
How Your Anatomy Failed
In your case, something caused the pillow to get crushed and there was a lack of padding in between the bones to protect the rope.
When that happened, the tendon started wearing against the bone when you would move.
The end result, is that both the rope and the surface of the pillow/bursa became irritated and inflamed.
Once that irritation and swelling started, even simple motions would keep it aggravated and Shoulder Impingement Syndrome is what it is called.
While it started out healthy, if you put a lot of pressure on the bursa steadily, for a long period of time, it can get squeezed out of shape.
Your arm is designed for repetitive motion, so if you are constantly raising and lowering your arm without much load, a healthy shoulder can do that endlessly without issue.
If though, you were doing a heavy motion over and over again, it may have been more than your bursa could handle.
Or, if you just have constant, mild pressure on your arm up into your collar bone for a long time - even when you're not moving - you can squeeze the bursa out of shape that way too.
This is what happened to the bursa in your shoulder.
Something was more than the bursa could handle, your tendon started rubbing against the bone, and Shoulder Impingement Syndrome set in.
Other Terms You Might Hear
You might hear many different terms used in what you read online or by your doctor.
You might be told you have an internal or external impingement.
It might be referred to as a Rotator Cuff Impingement.
You might be told the specific name of the muscle or tendon that involved.
But bottom line, the healing process will be the same regardless.
It's the same treatment you would do for Rotator Cuff Injury.
It really is a rotator cuff injury, it's just one special type of injury.
Healing the Damaged Tissue
In order to heal, there are 3 factors:
Reduce inflammation in the shoulder.
Protect the shoulder from further reinjury.
Let the damaged tissue heal.
Stopping any activity that may be causing the issue and resting are really core to getting better.
In time, that alone will heal most people
Yes, there are proactive treatments available to help with this, to speed the process, but with enough time and rest, most people will heal on their own.
Symptoms of Shoulder Impingement Injury
The shoulder is a complex part of the body.
You can experience pain in many ways and it might not be exactly what you read online or what you hear from other people.
Your injury is unique, and the symptoms you have may be unique as well.
That's ok and normal.
The most common symptoms are pain in the top of the shoulder and the side of the shoulder.
Sometimes the pain radiates down the arm.
The pain gets worse when you raise your arm especially if you lift it overhead.
Very often there is a shooting pain if you move your arm up to a certain point.
That pain is sharp enough and bad enough that you might develop some fear of moving the wrong way or reaching up at all.
Another common problem is people have pain and aching in the shoulder at night and it can be hard to find a good position to sleep.
Many people feel weakness in the arm.
Your shoulder could feel stiff or swollen.
You could have a dull ache all the time and sharp pain when you raise your arm to a certain point.
You may feel a pinching sensation when you raise your arm.
Not having a full range of motion is another possible symptom.
Some people cannot move their arm up above a certain point.
You might feel any combination of these symptoms.
Regardless of how your condition presents, focus on the steps to healing and your symptoms will improve rapidly.
What Causes Shoulder Impingement Syndrome
Shoulder Impingement can be caused by a number of things.
Most often it is a work or sports injury that built up over time from repetitive motions.
A job where you have to do a lot of overhead lifting like painting or construction work.
Or sports training that involves lifting overhead.
Sometimes people get a small injury that leads to impingement over time if not properly treated.
Isometric Strain
Postural problems can also play a role.
One point that is not addressed nearly enough is isometric strain.
Isometric strain is when you get into a position that puts stress or pressure on the shoulder joint for a long period of time.
Even if it isn't a lot of pressure, modest constant pressure over a long period can slowly flatten the bursa.
When this happens, it is slow to return and puff back up, so for a little while after isometric strain your shoulder is super vulnerable to injury
Remember this is your pillow and protector.
Once it is pressed flat it no longer provides the same cushion.
Sleep is Another Big Area to Consider.
There are two things to consider about your sleep.
One is just getting the right position where your shoulder does not hurt so you can get to sleep.
The other thing is making sure you are not causing reinjury during the night while sleeping.
Some people rest their head on their arm while sleeping.
This is not a good idea.
Whatever you do, don't sleep on your side or stomach with your arm up and using your shoulder as a pillow.
It might not hurt when you first get into the position but over a whole night of sleep it will cause isometric strain.
If you are a side sleeper then for most people you should sleep on the side that is not injured.
You will want to experiment with sleep positions to find one that is comfortable and prevents you from moving in a way that causes reinjury.
Some people report that they have to prop themselves up on pillows or in a recliner to sleep for a while.
Others use some pillows behind their back to keep from rolling over during the night.
Some people will sleep on their side and rest their arm on a pillow at just the right height.
With a little experimentation you can quickly find what works best for you.
Remember as you heal you might find that you must make some adjustments to what has been working for you.
Do not be afraid to change it up as you progress.
Some False Theories
Orthopedic surgeons have long had a theory that the shape of the Acromion was the cause of impingement.
They theorized that the bone bent downward or was thicker at the end and this caused impingement.
But only a small number of the people with these anatomical differences will ever experience impingement.
A significant percentage of people with this condition have what is termed an idiopathic shoulder impingement.
Idiopathic is what doctors call it when they have no idea what caused it.
Anything that causes excessive stress on the shoulder joint could cause inflammation of tissues in the shoulder.
Once you have inflammation, you have less room inside the shoulder for the tissues to move around.
With less room, you increase the chances that you will that the bony structures of the shoulder will rub against a tendon or bursa and cause inflammation, irritations and pain.
The Most Important Factor in Healing Your Shoulder Impingement
Your body is actively working to heal your Shoulder Impingement as you read this.
Without going into all the biology, your cells are diligently gathering building blocks to make new muscle and cartilage, assembling new tissues, and so on.
It is quickly going about this at the cellular level with no time to waste.
You do not have to think about it or do anything special.
Your body has a job to do and it is doing it.
Then you get up and do something that tweaks your shoulder.
You move your arm.
You do some simple tasks and feel that shooting, twinging pain in the shoulder.
You know it instantly.
It might be a different motion like reaching to the side or something.
You know you just aggravated your shoulder and it will ache more now.
But this is also the moment that you just reinjured your shoulder.
You just undid the healing that happened while you were at rest.
You have reinjured your damaged tissue.
You have undone some of the work your body just did for you while you were not moving.
The more you can avoid this scenario the more you can work with your body and not against it.
The more you work with your body the faster you heal.
This is the most important factor in healing from this injury.
That distinct, shooting, twinging Shoulder Impingement Pain is you undoing all the work you have done.
It is important to figure out how you can avoid those types of situations where you cause that pain.
How many times a day do you do the same things that cause that shooting twinge of pain?
Each time, you hurt your shoulder again.
Let's say your do this 6 times a day.
Even if you are can be successful in avoiding 3 of those incidents, you have cut your setbacks by half!
It helps to plan to avoid those situations where you might hurt yourself again.
Think back about all the things you have done that cause you to create that shooting reinjury pain.
What can you do to keep that from happening?
Grab the seatbelt and pull it out with your other arm?
Move your coffee cup down to a lower shelf?
Get help from others with certain tasks?
Even putting a shirt on can be the thing that sets off the shooting pain.
If you think about it a bit ahead of time, you can remember "problem actions" and anticipate them in the future.
One thing that helps a lot is putting your arm in a sling.
Not because it's broken, but it makes you think before using your bad arm.
When you are in a sling, you will be more likely to use your other arm.
If your injury is workplace related, you may really have to look at this at the main place to make adjustments to your daily routine to help you heal.
Let's say you had a job with lots of overhead reaching involved.
You will want to arrange things so that you can focus on tasks that don't require you to reach overhead.
Figuring these things out and making it so you can at least get a couple of weeks break from doing the things that aggravate your injury is very important.
The hardest part of this condition will be to give your shoulder the time needed to heal.
Exercise for Shoulder Impingement
There is a lot of advice out there about exercises for Shoulder Impingement Syndrome.
'General Impingement' exercises do not respect your specific injury.
You could have torn muscle, Tendonitis, or degenerative damage to cartilage.
Exercise will place stress directly on the damaged tissues.
Be careful of recommendations for exercises for Shoulder Impingement.
You need to be limiting the range of motion of your shoulder and arm and not put those muscles under load.
Avoid that shooting, sharp, "twinging" pain that signals you are reinjuring your Shoulder.
You should not be putting your damaged tissues under any intense stretch or load.
This means no gym. No heavy lifting. No swinging your arm.
Exercise is good once the pain is fully gone.
Before that, you are most likely just making your situation worse.
Yes, you can search "exercises for torn Shoulder Impingement" and find some but that does not mean those fit your situation.
That is for after healing to help prevent a future Rotator Cuff Syndrome.
In the early stages just ignore sites that tell you they have the one special exercise that will heal you instantly.
They don't.
Only do exercise if the area is stable enough for you to do it without ever having any pain.
Stretching for Shoulder Impingement Syndrome
Doing stretches for Shoulder Impingement Syndrome is another great way to make your shoulder worse.
You are taking irritated and inflamed tendons and putting them under direct stretch.
You have an injury to the tissues that are actively healing, and putting them under stretch will interrupt that healing process.
Right now, you need to be limiting the range of motion of your shoulder and arm.
Again, avoid that pain that signals you are reinjuring your Shoulder.
Doing exercise or stretches for a Shoulder Impingement is the opposite of taking steps to protect yourself.
You should not be putting your damaged tissues under any intense stretch or load.
No bendy poses.
No upper body yoga.
You are trying to heal.
To do that you need to give those torn and damaged fibers time.
You will hear people recommend stretching.
But only do stretches after the injury is stable enough to do it without ever having pain.
How Long Does Shoulder Impingement Syndrome Last?
This varies greatly.
Don't focus too much on other people's healing time.
They don't have the same injury.
However long it would normally take to heal on its own, you can speed up with proactive treatments.
Even without proactive treatments, in most cases, you can be out of pain in a month or two.
The key is to get enough rest and proper healing time.
Since reinjury is the number one factor slowing you down, having a realistic time frame for healing in mind is important.
If you are expecting to be healed in a week or two, you can't go out and do things that will reinjure your shoulder.
It often takes a few months to heal completely.
If your pain subsides in a few weeks and you go right back to normal, you may be stressing muscles that have not yet fully healed.
The pain stops when your injury is stable, not when it is fully healed.
By understanding the healing timeline, you won't go out and throw a baseball or lift luggage into the overhead in an airplane before you are fully ready.
Even once the pain is gone, know some things will reinjure you since you have not finished healing yet.
You can follow this link to better understand how your body tissue heals.
What Not to do When You Have a Shoulder Impingement
The internet is full of bad advice about treating your shoulder.
Here's a short list:
There no exercise that instantly heals you.
Stretching can cause reinjury.
Pain killers during the day will just cause you to strain your injury because you don't feel the pain of reinjury.
Driving through the pain will just make it worse.
You need to be aware of the risks and use the right pain meds at the right time.
Call our Treatment Advisors for proper guidance if you want to add medication to your treatment protocol.
What You Should do When You Have a Shoulder Impingement Syndrome?
For a little while - not forever - it is really helpful to give your shoulder a rest.
In many cases, resting your shoulder for a few weeks will give it time to heal to a point that your body feels it is ahead of the healing / reinjury cycle.
It's important to realize that once the pain and swelling go away, your underlying condition may not be completely gone, so take it easy and go back to regular life gradually.
Rotator Cuff Injuries and Shoulder Impingement are closely related conditions.
So, if you want to be more proactive about healing the problem, you can click here to visit the Recommended Treatments page.
Rest & Use Conservative Treatments
If you want your Shoulder Impingement Syndrome to go away as quickly as possible, you need to rest the affected shoulder.
Avoid any physical activities that could cause further injury to your shoulder.
Do your best to avoid the activity that caused the original injury.
Also avoid any activity that causes that twinge of shooting pain in your shoulder or arm.
Consider using a sling to keep the strain off your injured shoulder and avoid re-injury.
A sling doesn't mean don't move though, that's just to prevent you from doing strenuous activity or perhaps change a bad habit.
You can do regular ColdCure® treatments to control the pain and swelling.
The compression during each treatment helps soothe the aggravated tissue in the joint.
You can also focus on healing any and all tissue in the affected shoulder with regular BFST® treatments.
Your body wants to heal, so BFST will help it do that to the best of its ability.
This combination will work to finally get rid of your Shoulder Impingement Syndrome.
Medical Tape is another excellent way to protect area.
Professional athletes always use tape to protect their injuries.
That is because it works!
But it must be medical grade tape.
You are going to wear it all day long, and athletic tape is not safe for prolonged use.
You can find more information on this below in the recommended treatments section.
Don't do any stretching or strengthening exercises unless directed by your doctor.
Even then, you need to respect the pain.
If it hurts, you are not ready for the activity.
It is very easy to cause reinjury with stretching or strength exercises.
Remember, healing Shoulder Impingement Syndrome is a slow process, it may take a few months to get past it completely, but that's much better than ignoring it and suffering for a few years.
Continue doing BFST® treatments long after the pain disappears to maintain the healing you've done.
Do a ColdCure® treatment if you experience any flare-ups of pain and swelling and after any significant activity.
Rotator Cuff Injury and Shoulder Impingement Syndrome are closely related conditions.
Surgery Should Be a Last Resort
You don't have to undergo surgery in order to get rid of your issue.
You can get rid of your Shoulder Impingement Syndrome with conservative treatments.
Only in rare cases of significant damage would a person require surgery.
Avoid surgery at all costs.
Before any surgery, always get a second opinion.
Surgeons are always quite confident, because surgery is what they do.
That doesn't mean that's the right choice for you.
You want to do everything you can to let your shoulder heal on its own.
So first just give yourself time to heal and make surgery the very last resort.
If surgery is your only option, make sure your post-surgery recovery goes as smoothly as possible by using BFST and ColdCure.
Use a ColdCure® Wrap to reduce the inflammation and relieve the pain for the first few days following surgery.
Once the inflammation has gone down, promote blood flow to the injured area using a BFST® Wrap.
This will improve your circulation and help you heal faster.
Dealing With Shoulder Impingement Syndrome Pain
Painkillers are BAD, Not Good
Painkillers mask the pain, causing you to continue to stress and injure your shoulder.
This will only make your condition worse.
But shoulder impingement is an inflammatory condition and it can benefit from the correct use of the right medication.
You need to pick the right medication.
And you should not take them all day long.
You also need to be aware of the risks of long-term medication use.
You can use painkillers to help you sleep.
Call our Treatment Advisors for proper guidance if you want to add medication to your treatment protocol.
When it comes to Shoulder Impingement pain relief The ColdCure® Top Shoulder Wrap is designed to relieve the pain.
This safe and effective pain reliever is also great at bringing down swelling and inflammation.
The ColdCure® Wrap is incredibly soothing and provides support and protection for your shoulder.
The painkilling element is incredibly powerful and it works instantly - there's no 20-minute wait like with pills.
Shoulder Impingement Syndrome can be extremely painful and debilitating.
Painkillers such as ASA or acetaminophen are often used to treat the pain but these drugs do nothing to treat the actual condition.
In fact, painkillers are known blood thinners and make the bleeding worse for fresh tissue injuries.
Cortisone injections are used in extreme cases but these too are intended to only address the pain.
They do not promote healing of the injury itself and they put you at a very high risk of further injury.
Blood Flow is Essential for Healing
You don't have to wait for endless months in pain.
You can heal much more quickly with the right treatment.
For Shoulder Impingement Syndrome, blood flow is the most critical element in rapid recovery.
Blood flow feeds the damaged muscle fibers and ligaments in the shoulder.
Blood Flow Stimulation Therapy™ (BFST®) gives your shoulder the blood flow it needs to heal quickly and completely.
Don't fight your body, work with it to heal as quickly as possible.
BFST® brings extra oxygen and nutrient-rich blood to the injured area - a requirement for the body to heal itself.
Unfortunately, an injured shoulder at rest often has restricted blood flow, which extends your healing time and greatly increases the amount of scar tissue that your body has to deal with.
With a King Brand®BFST® shoulder Wrap, blood flow can be stimulated in the area of injury while you are at rest.
With improved blood flow and without strenuous physical activity and the risk of re-injury, you can recover from your Shoulder Impingement Injury at a rapid rate.
Since they are very closely related the treatment for Rotator Cuff Injury and Shoulder Impingement Syndrome is the same.
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In spite of the BFST® being an electrical device, BFST® can be used in hospital emergency rooms and operating rooms without affecting other equipment.
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It is not required by the government agencies, but we are also ISO-13485 compliant and registered.
This enforces medical standards that are established by the International Standards Organization for global manufacturers of medical devices.
This means more on-site, week long, audits every year, ensuring our quality and products meet strict international standards.
Beyond what is required by any regulator, we use only the safest materials in our products.
ISO-10993 regulation ensures that our products are made from higher quality materials than most baby products, including diapers.
This is the highest bio-compatibility safety standard in the world.
This is the highest hospital grade - think Intensive Care and Operating Rooms.
Our materials go through ISO-10993 testing to ensure they are safe for you.
No consumer products are produced to this high standard.
King Brand products are, in fact, hospital grade through and through.
IEC-60601 is the International Standard for Medical Device safety from an electrical standpoint.
In spite of the BFST® being an electrical device, BFST® can be used in hospital emergency rooms and operating rooms without affecting other equipment.
You can use any medical device with a BFST® and neither device will know the other one is there.
This is a very tough standard to meet, but we do it and you benefit.