The pain starts innocently enough. As you go about engaging in your recreational activities, you begin to notice some minor pain with overhead motions such as throwing a baseball/softball, or during your tennis serve. Soon, you start to notice pain when reaching up to the top cupboard to grab the syrup. Later on, you notice that you have pain when trying to sleep on that shoulder. Finally, many benign activities such as reaching for your toothbrush, putting on your bra, or scratching your opposite shoulder become very painful. You don’t remember an incident when you felt you hurt your shoulder, and are probably wondering what is causing all the pain. This insidious or slow onset of gradually increasing shoulder pain is a common sign of Shoulder Impingement Syndrome.
The dictionary defines impingement as “a sharp collision”. In the shoulder, impingement is usually a gradual process that can cause a lot of pain, especially when using the hands above the level of the shoulder. Shoulder impingement syndrome usually occurs when the supraspinatus tendon (one of your rotator cuff muscles) rubs against a part of the scapula (shoulder blade) called the Acromium. This rubbing /impingement of the muscle underneath the acromium can cause a chemical inflammation in the supraspinatus tendon that is felt as shoulder pain. This process is similar in the way that a rope will fray and unravel as it travels through a rough or narrow pulley. Often times, the bursae (a lubricating sack between the rotator cuff and the Acromium ) will become inflamed and irritated, leading to a condition called “Bursitis”. Left unchecked, this impingement process can progress to the point where the rotator cuff may eventually tear (either insidious or traumatic). If your rotator cuff tears, the chances of needing surgical intervention to relieve pain and restore normal function increase greatly.