Shoulder Impingement Specialist

Douglas J. Abeles M.D. & Associates

Orthopaedic Surgeons & Sports & Spine Surgery located in Castro Valley, CA

Sometimes called swimmer’s shoulder, shoulder impingement syndrome causes pain in the front and side of the joint when you move your arm through a throwing motion. Dr. Douglas Abeles of Douglas J. Abeles MD & Associates in Castro Valley, California, diagnoses and treats shoulder impingement to restore pain-free range of motion. Call today or book an appointment online.

Shoulder Impingement Q & A

Douglas J. Abeles M.D. & Associates

What is shoulder impingement?

The tendons of the rotator cuff pass through a bony arch called the acromion. With repeated motion such as with throwing a ball or swimming, these tendons may rub against bone and other tissue, which can cause irritation and inflammation in the tendons. Over time, tendon tissue may thicken in reaction to this rubbing, or impingement, which further aggravates the problem because there’s already too little room for these tendons to move.

Impingement syndrome isn’t a standalone diagnosis, as many other conditions can create or aggravate tendon inflammation. Shoulder impingement also may be a precursor to a rotator cuff tear if it’s left untreated.

How is shoulder impingement treated?

Because all movement of the arms involves the shoulders, impingement may be difficult to treat, as immobilizing your arms is impractical. The earliest stages of treatment typically use the RICE method:

  • Rest: Reduce the motion in the affected arm; pain indicates inflammation and delays healing
  • Ice: Use cold pack compression for 10 to 15 minutes at a time, starting every hour and reducing to three or four times a day as symptoms subside
  • Compression: Restrict motion and support the shoulder with wraps and braces
  • Elevation: Raising your arm above your head can aggravate impingement, so restrict elevation to upright positions and propping your upper body during sleep.

Dr. Abeles typically prescribes anti-inflammatories such as ibuprofen to counteract inflammation while providing pain relief. Therapies such as ultrasound and rehabilitative exercise also may be part of your treatment.

If these measures don’t produce results in 6-12 months, steroid injections may be used before Dr. Abeles considers surgical treatment.

What surgical options repair shoulder impingement?

The cause of the impingement dictates which surgical procedure can offer the best chance of success. In most cases, subacromial decompression surgery is the right option.

Because the space under the acromion is too small for the tendons, or, in some cases, may have bone spurs causing the irritation, Dr. Abeles typically uses arthroscopic and endoscopic techniques to enlarge the subacromial space, giving the tendons more room to move without irritation, medically called decompression.

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