Shoulder Impingement

Anatomy of the Shoulder Joint

The shoulder joint is the most mobile joint in the body that consists of three bones in a ball-and-socket structure: the upper arm bone or humerus, the shoulder blade or scapula, and the collarbone or clavicle. The joint is supported by a network of ligaments, tendons, and muscles that work together to provide stability and mobility. The rotator cuff maintains the arm in the shoulder socket, while muscles and tendons connect the humerus to the shoulder blade. Located between the rotator cuff and the acromion is a fluid-filled sac known as a bursa, which facilitates rotator cuff tendon movement.

What Are the Causes of Shoulder Impingement?

The most common cause of shoulder impingement in Singapore is repetitive overhead activities that cause strain on the bursa and tendons of the shoulder joint. Other causes of shoulder impingement include:

• Torn or Swollen Tendon - This occurs due to overuse from repetitive motion, trauma, or wear and tear.
• Inflamed Bursa - The bursa is a fluid-filled sac that provides support and glide for the muscles and tendons. This may lead to impingement when it becomes inflamed after repeated use.
• Unflattened Acromion - This is typically curved or hooked-shaped and is usually inherited.
• Bone Spurs - These growths develop in the acromion over time.
• Muscle Imbalance - This refers to the level of muscle tension or strength around the shoulder joint.

What Are the Symptoms of Shoulder Impingement?

A shoulder impingement often presents with the following symptoms:

• Pain in the Shoulder - Shoulder pain is a common symptom that is usually felt on the front and outer side of the shoulder and worsens with overhead activity.
• Weakness or Loss of Mobility - One may experience weakness in the affected shoulder along with limited range of motion.
• Tenderness - The tenderness associated with shoulder impingement is localised on the front of the shoulder and may also be an indication of inflammation and irritation of the tendons and bursa.
• Swelling - Swelling is usually mild to moderate and is often accompanied by warmth and redness at the front of the shoulder.

How Is Shoulder Impingement Diagnosed?

An accurate diagnosis of shoulder impingement is crucial to ensure proper treatment is given. Your doctor may assess the following:

• Physical Examination - A shoulder doctor in Singapore will conduct a detailed physical examination to assess the location and severity of the pain, range of motion, stability, and strength of the shoulder joint.
• Medical History - Patients will be asked about their medical history, including any previous shoulder injuries, the circumstances surrounding the onset of symptoms, as well as the duration and nature of the pain.
• Imaging Tests - The shoulder pain doctor will perform an X-ray to examine the bony structures of the shoulder joint and a magnetic resonance imaging (MRI) scan to obtain precise images of the soft tissues, such as the rotator cuff tendons.