Just above your rotator cuff, you have a fluid-filled sac called a bursa. The job of the bursa is to provide a cushion between tendons and bones. Bursa can become inflamed which can cause pain.
Shoulder impingement happens when that bursa gets irritated or pinched, usually in relation to the acromion (bone) and the rotator cuff. The long head of the biceps can also become inflamed in this setting. And what can irritate that bursa? Repetitive overhead movement.
Overhead lifters or athletes such as CrossFitters frequently have shoulder impingement issues, though they can happen to any population. The impingement or pinching of that bursa, rotator cuff and biceps tendon area happens from repeated overhead movement and lifts. You might feel pain in the front part of the shoulder, pain with overhead lifting, pushups, or overhead presses and pain on the outer portion of the shoulder that may wake you at night. It can feel similar to rotator cuff pain.
Typically to treat shoulder impingement we do a full shoulder rehab program focusing on scapular stabilization as well as the rotator cuff muscles. Often anti-inflammatory medications can be used, and a cortisone injection may also help, particularly when the athlete is having difficulty sleeping due to the pain.
The best way to prevent shoulder impingement is by sticking to a basic rotator cuff strengthening program with Jobe exercises and scapular stabilization. Doing maintenance therapy and recognizing symptoms so that you can receive early treatment and limit the time you are out of the activities that you love.
Margaret Lynch, PA-C, practices at OrthoCarolina’s Sports Medicine Center. Her clinical specialties include sports medicine and shoulder/elbow.