Shoulder Impingement Syndrome (Bursitis or Tendonitis)
Shoulder impingement syndrome involves one or a combination of problems,
including inflammation of the lubricating sac (bursa) located just over
the rotator cuff, a condition called shoulder bursitis; inflammation of
the rotator cuff tendons, called shoulder tendonitis; and calcium deposits
in tendons caused by wear and tear or injury. A torn rotator cuff is a
potential outcome of shoulder impingement.
Causes of Shoulder Impingement (Bursitis or Tendonitis)
Athletes, industrial workers and home maintenance buffs often suffer shoulder
pain caused by excessive rubbing or squeezing (impingement) of the rotator
cuff and shoulder blade.
Shoulder Bursitis: Frequent extension of the arm at high speed (i.e., pitching a baseball)
can cause bursitis. Nonsports activities such as painting, hanging wallpaper
or drapes or washing windows also can cause it. Medical research shows
that the older you get, the more likely you are to develop bursitis.
Shoulder Tendonitis: Tendonitis develops over time and is likely to occur when a person whose
muscles are not in good condition starts an overly aggressive training
program. In younger athletes, the causes of tendonitis are similar to
those of bursitis.
Symptoms of Shoulder Impingement, Shoulder Bursitis or Shoulder Tendonitis
Patients frequently try to ignore the first signs of shoulder problems.
There is usually no single episode of shoulder distress and, at first,
a person may notice only minor pain and a slight loss of strength. A loss
of the range of motion, especially the ability to lift the arm overhead,
may be ignored for awhile. Symptoms of shoulder bursitis include mild
to severe pain and limited movement. An inability to hold the arm in certain
positions indicates tendonitis is present. Recurrent episodes of tendonitis
may indicate a rotator cuff tear.
Treatment for Shoulder Impingement, Shoulder Bursitis or Shoulder Tendonitis
Shoulder Bursitis: Once bursitis is diagnosed, rest is the recommended treatment. If necessary,
icepacks can also be prescribed, as well as anti-inflammatory drugs, steroid
injections and ultrasound therapy. Some patients require temporary use
of a sling. After inflammation subsides, the patient should do shoulder
Shoulder Tendonitis: Acute tendonitis usually passes if the activity which caused it is avoided
long enough to give the shoulder sufficient rest. Later, a patient can
gradually resume the activity incorporating gentle heat and prescribed
stretching beforehand and icepacks afterward. More severe cases may require
anti-inflammatory drugs or a cortisone injection.
With either shoulder bursitis or shoulder tendonitis, severe cases may