IMPINGEMENT OF THE SHOULDER (SWIMMER'S SHOULDER)

WHAT IS IMPINGEMENT (BUILD-UP OF SCAR TISSUE)?

A common cause of shoulder joint pain is impingement. Impingement occurs when structures within the shoulder (such as tendons and bones) rub together and cause inflammation of the rotator cuff- tendinitis, and of the surrounding bursa- bursitis. If the condition occurs in swimmers, it is called a swimmers shoulder.

The space between the acromion and the rotator cuff is filled with the sub-acromial bursa, a fluid-filled sac that allows the shoulder to move properly. Any unusual impact on the rotator cuff can cause shoulder joint pain and impingement.

Conditions that can impact the function of the rotator cuff and potentially contribute to impingement are:

• Rotator cuff strain
• Rotator cuff tears
• Calcification
• Wear and tear of the rotator cuff caused by overuse and sports like tennis and swimming.

WHAT ARE THE SYMPTOMS?

Symptoms of impingement or rotator cuff injury include:

• Shoulder pain at rest
• Pain on movement of the shoulder
• Swelling
• Joint stiffness
• Weakness
• Difficulty lifting the arm

WHAT ARE THE TREATMENT OPTIONS?

Your orthopaedic doctor will check your shoulder for tenderness and check the function and strength of your arm and shoulder. He will rule out other potential conditions such as arthritis before proceeding with available treatment options. Your doctor will use x-rays, ultrasound or magnetic resonance imaging (MRI) to check for abnormalities.

Some non-surgical treatments for Swimmer’s shoulder include:

• Anti-inflammatory medication
• Physiotherapy or sports therapy
• Cortisone injections
• Rest

If all treatment options have been exhausted and there is no pain relief, your orthopaedic surgeon may recommend shoulder impingement surgery. The surgical procedure will help to create more space for the rotator cuff. Your surgeon will remove a part of the acromion as well as the inflamed part of the bursa, ultimately minimising the pain in your rotator cuff. In this case, Dr Pirjol will conduct an arthroscopy of the shoulder, during which he will insert a small camera into your shoulder joint. Images will then be displayed on screens as he guides small surgical tools to perform the desired surgery.