Impingement (Tendinitis, Bursitis, AC Arthritis)

At Slocum Center in Eugene, Oregon, our shoulder surgeons are experts in treating shoulder impingement. This may also be referred to as tendinitis, bursitis, and AC arthritis. Our team of shoulder specialists have been treating shoulder impingement for more than four decades. That means your shoulder condition will be cared for by a team whose skill-set is unmatched in the area. 

Cause

The most common causes of pain in the adult shoulder result from shoulder impingement syndrome. This occurs when the long roof of the shoulder puts pressure on the rotator cuff tendons as the arm is lifted. The rotator cuff travels through a narrow arch, which can rub or impinge on the surface of these tendons. The pain may be due to inflammation and swelling of the tendons and bursae that overly the rotator cuff. In some circumstances, a partial tear of the rotator cuff may cause impingement pain. Arthritic change of the AC joint may also contribute.

Prevention

Both young athletes and middle-aged people experience impingement. Young athletes who use their arms overhead for swimming, baseball, and tennis are particularly vulnerable. Those who do repetitive lifting or overhead activities using the arm, such as paper hanging, construction, or painting are also susceptible. Pain may also develop as the result of minor trauma or spontaneously with no apparent cause.

Treatment

Resting, a course of oral non-steroidal anti-inflammatory medication, and avoiding overhead activities are often the first steps. Stretching exercises can improve range of motion, and an injection of local anesthetic and a cortisone preparation to the affected area may help. An orthopedist might also recommend a program of supervised physical therapy. Treatment may take several weeks to months. Many patients experience a gradual improvement and return to function.

If function does not improve, surgery may be necessary. Through surgery, the impinging structures can be removed, creating more space for the rotator cuff. The most common surgical treatment is subacromial decompression. Calcium deposits can be removed if necessary. Resection of the arthritis from the AC joint and treatment of inflamed biceps may also may also be necessary. Usually, these procedures are done arthroscopically or through a mini-open approach.

Additional Information