Impingement Syndrome

1
Impingement Syndrome

• Rotator cuff tendonitis and tear

2
Anatomy of Shoulder

• Rotator cuff muscles
• Subscaplaris
• Supraspinatus
• Infraspinatus
• Teres minor

3
Definition

• Rotator cuff tendonitis and tears
• Inflammation and irritation of subacromial bursa
  (bursitis)

4
Causes

• A sudden violent movement of shoulder
• Chronic overuse of shoulder in overhead activities

• A direct blow to the shoulder
• A gall onto an outstretched hand
• A shoulder dislocation
• Degeneration of rotator cuff

5
Diagnosis

• Pain with overheard arm activities
• Tenderness
• Weakness of rotator cuff muscles
• A decreased range of motion of the shoulder
• X-rays
• Occasionally, MRI or shoulder arthroscopy

6
Treatment

• Nonoperatative
• Rest
• Anti-inflammatory medication
• Physical therapy
• Occasionally steroid injection to reduce pain in
  older patients

7
Treatment

• Operative
• Remove bursitis

• Subacromial Decompression
• Open up the space available for the rotator cuff
  by shaving down spurs

• Repair or reattachment of torn rotator cuff
  tendons

8
Surgical Results
Before Surgery After Surgery
Removal Bursitis
Subacromial Depression
9
Prevention

• Strengthening
• Avoid repetitive overhead activity
• Improving the flexibility

10
Reference

• EMDEx
• Shoulder Solutions