Materiały źródłowe

• #1 Shoulder Impingement (Rotator Cuff Tendinitis)

  https://my.clevelandclinic.org/health/diseases/shoulder-impingement-rotator-cuff-tendinitis

  Shoulder impingement happens when bones in your shoulder rub against or pinch your rotator cuff. It happens when swelling in your shoulder makes your rotator cuff too big to fit comfortably between your bones. […] Shoulder impingement happens when the top outer edge of your shoulder blade (scapula) pinches your rotator cuff beneath it. […] Impingement is the medical term for pinching or rubbing together inside a joint. It causes pain, especially when you move. […] Visit a healthcare provider if you’re experiencing shoulder pain or can’t move your shoulder without pain. […] A healthcare provider might classify shoulder impingement as a more specific issue, including: Rotator cuff tendinitis: Rotator cuff tendinitis is exactly what its name sounds like tendinitis that affects your rotator cuff.

• #2 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  Rotator cuff impingement syndrome and associated rotator cuff tears are commonly encountered shoulder problems. Symptoms include pain, weakness and loss of motion. Causes of impingement include acromioclavicular joint arthritis, calcified coracoacromial ligament, structural abnormalities of the acromion and weakness of the rotator cuff muscles. Conservative treatment (rest, ice packs, nonsteroidal anti-inflammatory drugs and physical therapy) is usually sufficient. Some patients benefit from steroid injection, and a few require surgery. […] Family physicians who understand rotator cuff pathology and can perform a concise examination of the shoulder can readily diagnose and treat impingement and tears of the rotator cuff. This article reviews the rotator cuff syndrome and lays a foundation for its appropriate recognition and treatment.

• #3 Shoulder Impingement (Care of the Young Athlete)

  https://www.westalabamapeds.com/sports/Shoulder-Impingement-Care-of-the-Young-Athlete

  Shoulder impingement is an overuse injury that causes achy pain on the front or side of the shoulder. The pain is felt most when the arm is overhead or extended to the side. Shoulder impingement also is called rotator cuff tendonitis, subacromial impingement, supraspinatus tendonitis, and shoulder bursitis. […] Treating shoulder impingement involves limiting activities that cause pain and using ice and nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation. The symptoms of shoulder impingement will subside with rest, but the condition will not fully resolve until the underlying causes have been identified and corrected. […] 1. Limit overhead activity or anything that causes pain. […] 2. Ice, NSAIDs. […] 1. The other phases of rehabilitation will not be effective until pain is controlled.

• #4 Shoulder Impingement Syndrome | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/shoulder-impingement-syndrome

  Shoulder impingement syndrome (SIS) is a common cause of shoulder pain in adults. People with the condition experience pain related to the shoulder’s tendons and soft tissues when lifting the arm overhead. […] Many patients with SIS get better with rest and physical therapy. Pain medications can also be useful, and in some cases, cortisone injections into the shoulder joint can reduce pain and swelling, aiding recovery. […] Initial treatment of SIS generally involves conservative measures such as physical therapy and pain-relieving medications. Most patients benefit from a course of physical therapy focused on stretching the shoulder and strengthening the rotator cuff and scapular muscles, as well as postural exercises to address the position of the shoulder blade. […] For patients whose pain doesn’t respond to conservative measures, our orthopedic surgeons have expertise in shoulder impingement.

• #5 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  Rotator cuff impingement syndrome and associated rotator cuff tears are commonly encountered shoulder problems. Symptoms include pain, weakness and loss of motion. Causes of impingement include acromioclavicular joint arthritis, calcified coracoacromial ligament, structural abnormalities of the acromion and weakness of the rotator cuff muscles. Conservative treatment (rest, ice packs, nonsteroidal anti-inflammatory drugs and physical therapy) is usually sufficient. Some patients benefit from steroid injection, and a few require surgery. […] Family physicians who understand rotator cuff pathology and can perform a concise examination of the shoulder can readily diagnose and treat impingement and tears of the rotator cuff. This article reviews the rotator cuff syndrome and lays a foundation for its appropriate recognition and treatment.

• #6 Shoulder Impingement Treatment at Southern Joint Replacement Institute | Southern Joint Replacement Institute

  https://sjri.com/service/shoulder-impingement

  A common cause of shoulder pain is shoulder impingement syndrome. Risk factors for impingement of the shoulder tendons or bursa include: […] Shoulder impingement is possible if the shoulder joint is overused in activities such as lifting, tennis, painting, swimming and other overhead work or sports. […] The pain of shoulder impingement is persistent. Daily activities, like putting on a coat, can be painful and difficult. Any motion reaching overhead or up behind the back may cause pain. […] Shoulder impingement can lead to two conditions: […] Weakness and pain of the arm and shoulder muscles is a common symptom. […] If left untreated, the shoulders rotator cuff tendons can become thin and tear. Injury of the tendons over time can have serious consequences – the tendon can tear in two, causing a rotator cuff tear that makes it difficult to elevate the arm.

• #7 Shoulder Impingement (Care of the Young Athlete)

  https://www.westalabamapeds.com/sports/Shoulder-Impingement-Care-of-the-Young-Athlete

  Shoulder impingement is an overuse injury that causes achy pain on the front or side of the shoulder. The pain is felt most when the arm is overhead or extended to the side. Shoulder impingement also is called rotator cuff tendonitis, subacromial impingement, supraspinatus tendonitis, and shoulder bursitis. […] Treating shoulder impingement involves limiting activities that cause pain and using ice and nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation. The symptoms of shoulder impingement will subside with rest, but the condition will not fully resolve until the underlying causes have been identified and corrected. […] 1. Limit overhead activity or anything that causes pain. […] 2. Ice, NSAIDs. […] 1. The other phases of rehabilitation will not be effective until pain is controlled.

• #8 Shoulder Exam Tutorial | Stanford Medicine 25 | Stanford Medicine

  https://stanfordmedicine25.stanford.edu/the25/shoulder.html

  Shoulder impingement nursing care involves understanding the condition and its implications for patient management. In the shoulder impingement syndrome, the tendon of the supraspinatus is inflamed as a consequence of repetitive trauma to its subacromial portion. Any processes that reduce the subacromial space together with repetitive overhead motion of the shoulder may contribute to the development of this condition. It usually manifests as shoulder pain, particularly at night, and weakness in the overhead extension of the arms. […] We can use three tests to check for the presence of shoulder impingement: – Neers Test – Empty Can Test – Hawkins-Kennedy Test. […] Patients with shoulder impingement may also have tenderness upon palpation of the anterior joint line. […] Also, scapular movement asymmetries are frequently associated with shoulder impingement.

• #9 Shoulder Impingement (Rotator Cuff Tendinitis)

  https://my.clevelandclinic.org/health/diseases/shoulder-impingement-rotator-cuff-tendinitis

  Shoulder impingement happens when bones in your shoulder rub against or pinch your rotator cuff. It happens when swelling in your shoulder makes your rotator cuff too big to fit comfortably between your bones. […] Shoulder impingement happens when the top outer edge of your shoulder blade (scapula) pinches your rotator cuff beneath it. […] Impingement is the medical term for pinching or rubbing together inside a joint. It causes pain, especially when you move. […] Visit a healthcare provider if you’re experiencing shoulder pain or can’t move your shoulder without pain. […] A healthcare provider might classify shoulder impingement as a more specific issue, including: Rotator cuff tendinitis: Rotator cuff tendinitis is exactly what its name sounds like tendinitis that affects your rotator cuff.

• #10 Shoulder Impingement Treatment at Southern Joint Replacement Institute | Southern Joint Replacement Institute

  https://sjri.com/service/shoulder-impingement

  A common cause of shoulder pain is shoulder impingement syndrome. Risk factors for impingement of the shoulder tendons or bursa include: […] Shoulder impingement is possible if the shoulder joint is overused in activities such as lifting, tennis, painting, swimming and other overhead work or sports. […] The pain of shoulder impingement is persistent. Daily activities, like putting on a coat, can be painful and difficult. Any motion reaching overhead or up behind the back may cause pain. […] Shoulder impingement can lead to two conditions: […] Weakness and pain of the arm and shoulder muscles is a common symptom. […] If left untreated, the shoulders rotator cuff tendons can become thin and tear. Injury of the tendons over time can have serious consequences – the tendon can tear in two, causing a rotator cuff tear that makes it difficult to elevate the arm.

• #11 Shoulder Impingement Syndrome: Symptoms & Treatment | HSS

  https://www.hss.edu/condition-list_shoulder-impingement.asp

  In general, shoulder impingement refers to cases in which tissue such as a tendon or bursa becomes (or pinched) compressed (impinged) around the shoulder joint. […] The term shoulder impingement syndrome is sometimes used to describe a broader array of associated symptoms and related conditions of the shoulder. […] The most common symptoms of shoulder impingement are shoulder pain (especially while reaching or throwing overhead), stiffness, tenderness to the touch and/or weakness. […] Pain may be sharp and localized (often during activity) or dull and diffuse (especially while lying down at rest). […] Your doctor will diagnose shoulder impingement based on your medical history (typically the most important part of the intake and can lead to the right diagnosis), a physical examination and, usually, imaging tests such as an X-ray or MRI to confirm a diagnosis.

• #12 Shoulder Impingement Syndrome: Symptoms & Treatment | HSS

  https://www.hss.edu/condition-list_shoulder-impingement.asp

  In general, shoulder impingement refers to cases in which tissue such as a tendon or bursa becomes (or pinched) compressed (impinged) around the shoulder joint. […] The term shoulder impingement syndrome is sometimes used to describe a broader array of associated symptoms and related conditions of the shoulder. […] The most common symptoms of shoulder impingement are shoulder pain (especially while reaching or throwing overhead), stiffness, tenderness to the touch and/or weakness. […] Pain may be sharp and localized (often during activity) or dull and diffuse (especially while lying down at rest). […] Your doctor will diagnose shoulder impingement based on your medical history (typically the most important part of the intake and can lead to the right diagnosis), a physical examination and, usually, imaging tests such as an X-ray or MRI to confirm a diagnosis.

• #13 Rotator Cuff Impingement | The Steadman Clinic

  https://www.thesteadmanclinic.com/patient-education/shoulder/rotator-cuff-impingement

  Shoulder impingement syndrome occurs when the tendons of the rotator cuff and the subacromial bursa are pinched in the narrow space beneath the acromion. This causes the tendons and bursa to become inflamed and swollen. This pinching is worse when the arm is raised away from the side of the body. Impingement may develop over time as a result of a minor injury, or as a result of repetitive motions that lead to inflammation in the bursa. […] Impingement is classified in three grades: Grade I is marked by inflammation of the bursa and tendons; Grade II has progressive thickening and scarring of the bursa; Grade III occurs when rotator cuff degeneration and tears are evident. […] Treatment for both injuries usually begins with a non-operative treatment plan. More than 2/3 of impingement patients can expect significant improvement in their symptoms with a physical therapy program alone.

• #14 Shoulder Impingement (Rotator Cuff Tendinitis)

  https://my.clevelandclinic.org/health/diseases/shoulder-impingement-rotator-cuff-tendinitis

  Shoulder impingement happens when bones in your shoulder rub against or pinch your rotator cuff. It happens when swelling in your shoulder makes your rotator cuff too big to fit comfortably between your bones. […] Shoulder impingement happens when the top outer edge of your shoulder blade (scapula) pinches your rotator cuff beneath it. […] Impingement is the medical term for pinching or rubbing together inside a joint. It causes pain, especially when you move. […] Visit a healthcare provider if you’re experiencing shoulder pain or can’t move your shoulder without pain. […] A healthcare provider might classify shoulder impingement as a more specific issue, including: Rotator cuff tendinitis: Rotator cuff tendinitis is exactly what its name sounds like tendinitis that affects your rotator cuff.

• #15 Shoulder Impingement Syndrome: Symptoms & Treatment | HSS

  https://www.hss.edu/condition-list_shoulder-impingement.asp

  In general, shoulder impingement refers to cases in which tissue such as a tendon or bursa becomes (or pinched) compressed (impinged) around the shoulder joint. […] The term shoulder impingement syndrome is sometimes used to describe a broader array of associated symptoms and related conditions of the shoulder. […] The most common symptoms of shoulder impingement are shoulder pain (especially while reaching or throwing overhead), stiffness, tenderness to the touch and/or weakness. […] Pain may be sharp and localized (often during activity) or dull and diffuse (especially while lying down at rest). […] Your doctor will diagnose shoulder impingement based on your medical history (typically the most important part of the intake and can lead to the right diagnosis), a physical examination and, usually, imaging tests such as an X-ray or MRI to confirm a diagnosis.

• #16 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  Rotator cuff impingement syndrome and associated rotator cuff tears are commonly encountered shoulder problems. Symptoms include pain, weakness and loss of motion. Causes of impingement include acromioclavicular joint arthritis, calcified coracoacromial ligament, structural abnormalities of the acromion and weakness of the rotator cuff muscles. Conservative treatment (rest, ice packs, nonsteroidal anti-inflammatory drugs and physical therapy) is usually sufficient. Some patients benefit from steroid injection, and a few require surgery. […] Family physicians who understand rotator cuff pathology and can perform a concise examination of the shoulder can readily diagnose and treat impingement and tears of the rotator cuff. This article reviews the rotator cuff syndrome and lays a foundation for its appropriate recognition and treatment.

• #17 Shoulder Exam Tutorial | Stanford Medicine 25 | Stanford Medicine

  https://stanfordmedicine25.stanford.edu/the25/shoulder.html

  Shoulder impingement nursing care involves understanding the condition and its implications for patient management. In the shoulder impingement syndrome, the tendon of the supraspinatus is inflamed as a consequence of repetitive trauma to its subacromial portion. Any processes that reduce the subacromial space together with repetitive overhead motion of the shoulder may contribute to the development of this condition. It usually manifests as shoulder pain, particularly at night, and weakness in the overhead extension of the arms. […] We can use three tests to check for the presence of shoulder impingement: – Neers Test – Empty Can Test – Hawkins-Kennedy Test. […] Patients with shoulder impingement may also have tenderness upon palpation of the anterior joint line. […] Also, scapular movement asymmetries are frequently associated with shoulder impingement.

• #18 Shoulder Exam Tutorial | Stanford Medicine 25 | Stanford Medicine

  https://stanfordmedicine25.stanford.edu/the25/shoulder.html

  Shoulder impingement nursing care involves understanding the condition and its implications for patient management. In the shoulder impingement syndrome, the tendon of the supraspinatus is inflamed as a consequence of repetitive trauma to its subacromial portion. Any processes that reduce the subacromial space together with repetitive overhead motion of the shoulder may contribute to the development of this condition. It usually manifests as shoulder pain, particularly at night, and weakness in the overhead extension of the arms. […] We can use three tests to check for the presence of shoulder impingement: – Neers Test – Empty Can Test – Hawkins-Kennedy Test. […] Patients with shoulder impingement may also have tenderness upon palpation of the anterior joint line. […] Also, scapular movement asymmetries are frequently associated with shoulder impingement.

• #19 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti-inflammatory drugs (NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization. […] Once the acute pain resolves, a specific strengthening program for the rotator cuff is recommended for prevention of future injuries. The motions of the rotator cuff that are emphasized for strengthening are internal rotation, external rotation and abduction. It is important to remember that the function of the rotator cuff, in addition to generating torque, is to stabilize the glenohumeral joint; thus, stronger rotator cuff muscles result in better glenohumeral joint stabilization and less impingement.

• #20 Shoulder Impingement Causes, Symptoms, and Treatments

  https://www.upmc.com/services/orthopaedics/conditions/shoulder-impingements

  Shoulder impingement happens when bone rubs against tissue in the your shoulder joint, causing pain. It’s common in athletes and people who do repetitive, overhead movements for work. […] Most cases dramatically improve with rest, shoulder impingement exercises, and medicine. […] Impingement syndrome requires rest, physical therapy, and in some cases, surgery. Without treatment, the problem will likely get worse over time. […] Follow these tips to avoid shoulder impingement: If you experience pain in the shoulder, take a break from whatever movements increase pain. […] Your doctor will tell you what movements to avoid, and for how long. If you have shoulder impingement, you should avoid throwing, lifting anything above your head, or swinging your arms high. […] As your shoulder impingement heals, your physical therapist or orthopaedic doctor will introduce shoulder impingement exercises. By strengthening weaker muscles, you can relieve overused muscles.

• #21 Shoulder Impingement (Rotator Cuff Tendinitis)

  https://my.clevelandclinic.org/health/diseases/shoulder-impingement-rotator-cuff-tendinitis

  Tendinitis is swelling or irritation of a tendon. […] Anything that irritates or damages your tendons can make them swell. This swelling causes shoulder impingement. […] Your provider will suggest treatments that manage your symptoms and help your shoulder heal and regain its usual function. The most common shoulder impingement treatments include: Rest: Taking a break from physical activity especially the sport or activity that caused the impingement. […] Physical therapy: A physical therapist will give you stretches and exercises to strengthen your shoulder and improve its range of motion. […] Rotator cuff tendinitis treatments usually include all the same treatments for other types of shoulder impingement. Your provider will suggest the best ways to help your rotator cuff tendons heal.

• #22 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti-inflammatory drugs (NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization. […] Once the acute pain resolves, a specific strengthening program for the rotator cuff is recommended for prevention of future injuries. The motions of the rotator cuff that are emphasized for strengthening are internal rotation, external rotation and abduction. It is important to remember that the function of the rotator cuff, in addition to generating torque, is to stabilize the glenohumeral joint; thus, stronger rotator cuff muscles result in better glenohumeral joint stabilization and less impingement.

• #23 Shoulder Impingement (Care of the Young Athlete)

  https://www.westalabamapeds.com/sports/Shoulder-Impingement-Care-of-the-Young-Athlete

  Shoulder impingement is an overuse injury that causes achy pain on the front or side of the shoulder. The pain is felt most when the arm is overhead or extended to the side. Shoulder impingement also is called rotator cuff tendonitis, subacromial impingement, supraspinatus tendonitis, and shoulder bursitis. […] Treating shoulder impingement involves limiting activities that cause pain and using ice and nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation. The symptoms of shoulder impingement will subside with rest, but the condition will not fully resolve until the underlying causes have been identified and corrected. […] 1. Limit overhead activity or anything that causes pain. […] 2. Ice, NSAIDs. […] 1. The other phases of rehabilitation will not be effective until pain is controlled.

• #24 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti-inflammatory drugs (NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization. […] Once the acute pain resolves, a specific strengthening program for the rotator cuff is recommended for prevention of future injuries. The motions of the rotator cuff that are emphasized for strengthening are internal rotation, external rotation and abduction. It is important to remember that the function of the rotator cuff, in addition to generating torque, is to stabilize the glenohumeral joint; thus, stronger rotator cuff muscles result in better glenohumeral joint stabilization and less impingement.

• #25 Shoulder Impingement (Care of the Young Athlete)

  https://www.westalabamapeds.com/sports/Shoulder-Impingement-Care-of-the-Young-Athlete

  Shoulder impingement is an overuse injury that causes achy pain on the front or side of the shoulder. The pain is felt most when the arm is overhead or extended to the side. Shoulder impingement also is called rotator cuff tendonitis, subacromial impingement, supraspinatus tendonitis, and shoulder bursitis. […] Treating shoulder impingement involves limiting activities that cause pain and using ice and nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation. The symptoms of shoulder impingement will subside with rest, but the condition will not fully resolve until the underlying causes have been identified and corrected. […] 1. Limit overhead activity or anything that causes pain. […] 2. Ice, NSAIDs. […] 1. The other phases of rehabilitation will not be effective until pain is controlled.

• #26 Shoulder Impingement Treatment at Southern Joint Replacement Institute | Southern Joint Replacement Institute

  https://sjri.com/service/shoulder-impingement

  The most common treatment for shoulder impingement is an oral anti-inflammatory medication, such as naproxen, ibuprofen, or aspirin for a duration of six to eight weeks. […] Cortisone-type injections may be prescribed if persistent symptoms do not respond well to anti-inflammatory drugs. […] Your SJRI doctor may also apply these treatments in addition to medications: […] Most patients respond well to these treatments. […] Significant weakness or other symptoms that persist regardless of treatment may indicate a rotator cuff tear.

• #27 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  Patients with stage II impingement may require a formal physical therapy program. Isometric stretches are useful in restoring range of motion. Isotonic (fixed-weight) exercises are preferable to variable weight exercises. […] Therapeutic injections (lidocaine plus a corticosteroid) are useful both because they are therapeutic and also because they can help the physician differentiate impingement from other problems. Indications for therapeutic injections include the following: Rotator cuff impingement that does not improve with conservative treatment, including NSAIDs and physical therapy. […] Not all cuff tears diagnosed clinically, or by arthography or MRI require surgical repair. A rotator cuff tear is not, in itself, an indication for surgery. […] Most older patients with impingement and rotator cuff tears actually do well without surgery. However, surgery might be considered in a patient who has failed to improve after six months of conservative treatment or in a patient less than 60 years of age with a debilitating tear that impairs function.

• #28 Patient education: Shoulder impingement syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/shoulder-impingement-syndrome-beyond-the-basics/print

  Health care providers sometimes suggest injections of medications called glucocorticoids, known commonly as „steroids,” directly into the shoulder, beneath a bone called the acromion. Steroids help to relieve inflammation and pain, and consequently make it easier for you to perform physical therapy effectively. […] Two to four weeks after starting treatment for shoulder impingement syndrome (SIS), you should follow up with your health care provider to see how your symptoms are progressing and check whether any aspect of treatment should change. After that, your follow-up will be directed by your doctor, physical therapist, or other health care provider. You may need additional guidance on how to resume normal activities. […] Once the pain has resolved and you regain full range of motion, strength, and shoulder stability, you can resume your usual activities. It’s best to start slow and gradually increase your activity level.

• #29 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  Patients with stage II impingement may require a formal physical therapy program. Isometric stretches are useful in restoring range of motion. Isotonic (fixed-weight) exercises are preferable to variable weight exercises. […] Therapeutic injections (lidocaine plus a corticosteroid) are useful both because they are therapeutic and also because they can help the physician differentiate impingement from other problems. Indications for therapeutic injections include the following: Rotator cuff impingement that does not improve with conservative treatment, including NSAIDs and physical therapy. […] Not all cuff tears diagnosed clinically, or by arthography or MRI require surgical repair. A rotator cuff tear is not, in itself, an indication for surgery. […] Most older patients with impingement and rotator cuff tears actually do well without surgery. However, surgery might be considered in a patient who has failed to improve after six months of conservative treatment or in a patient less than 60 years of age with a debilitating tear that impairs function.

• #30 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  Shoulder impingement syndrome is a painful condition of the upper extremity resulting from a structural narrowing of the subacromial space. […] The mainstay of treatment involves identification early before the onset of degenerative changes, physical therapy exercises to strengthen the shoulder girdle, and pharmacologic interventions to decrease inflammation. […] This activity describes the evaluation and management of shoulder impingement syndrome and highlights the role of an interprofessional team in the care of patients with this condition. […] Physiotherapy for shoulder impingement syndrome should consist of exercises that focus on rotator cuff strengthening, with a special focus on the supraspinatus and infraspinatus rotator cuff muscles, the trapezius, and serratus anterior strengthening and retraining exercises to minimize scapular dyskinesia, and other exercises to correct strength imbalances of the upper extremities.

• #31 Optimal management of shoulder impingement syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3945046/

  Before the initiation of the therapy program, it is imperative to perform a complete and thorough evaluation. This will enable the clinician to establish an accurate diagnosis, identify all causative factors, and determine the involved structure or structures. This will allow the rehabilitation specialist to implement an individualized treatment program to address these factors and prioritize the treatment goals. The primary emphasis of the treatment program is to reduce the mechanical irritation to the rotator cuff and promote a restoration in tendon vascularity that can result from muscle guarding, mechanical compression, and abnormal shoulder mechanics. […] The nonoperative rehabilitation program outlined in this article for the treatment of shoulder impingement is a multiphased approach focused on a return to prior level of function via a systematic process. This treatment program is outlined in Table 4 and consists of four phases that are a gradual progression of exercises and implied stresses that increase and become more demanding than those of the previous phase of treatment. The effectiveness of the treatment program is based on the identification of the underlying causative factor or factors and the individualized program designed to address this condition.

• #32 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  Shoulder impingement syndrome is a painful condition of the upper extremity resulting from a structural narrowing of the subacromial space. […] The mainstay of treatment involves identification early before the onset of degenerative changes, physical therapy exercises to strengthen the shoulder girdle, and pharmacologic interventions to decrease inflammation. […] This activity describes the evaluation and management of shoulder impingement syndrome and highlights the role of an interprofessional team in the care of patients with this condition. […] Physiotherapy for shoulder impingement syndrome should consist of exercises that focus on rotator cuff strengthening, with a special focus on the supraspinatus and infraspinatus rotator cuff muscles, the trapezius, and serratus anterior strengthening and retraining exercises to minimize scapular dyskinesia, and other exercises to correct strength imbalances of the upper extremities.

• #33 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti-inflammatory drugs (NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization. […] Once the acute pain resolves, a specific strengthening program for the rotator cuff is recommended for prevention of future injuries. The motions of the rotator cuff that are emphasized for strengthening are internal rotation, external rotation and abduction. It is important to remember that the function of the rotator cuff, in addition to generating torque, is to stabilize the glenohumeral joint; thus, stronger rotator cuff muscles result in better glenohumeral joint stabilization and less impingement.

• #34 Shoulder Impingement (Care of the Young Athlete)

  https://www.westalabamapeds.com/sports/Shoulder-Impingement-Care-of-the-Young-Athlete

  2. Swelling inside the shoulder may worsen the pain and contribute to further injury. […] 3. Pain may be reduced by limiting activities or changing technique for painful activities. […] Proper posture is very importantchest out and shoulders back. These exercises strengthen parts of the body that help with posture and holding the shoulder bones in the proper position. […] Strength in the legs, hips, and trunk is crucial for maximizing arm strength and power with throwing or tennis. This part of rehabilitation can usually take place while shoulder pain is subsiding. […] Continue with maintenance exercises that have been prescribed and any corrections in technique or training regimens that helped with recovery. Include exercises that help prevent the strength imbalances that occur with repetitive overhead activity and contribute to injury. Athletes should continue select important exercises after therapy. These are typically not as extensive or time-consuming as the rehabilitation program.

• #35 Patient education: Shoulder impingement syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/shoulder-impingement-syndrome-beyond-the-basics/print

  Health care providers sometimes suggest injections of medications called glucocorticoids, known commonly as „steroids,” directly into the shoulder, beneath a bone called the acromion. Steroids help to relieve inflammation and pain, and consequently make it easier for you to perform physical therapy effectively. […] Two to four weeks after starting treatment for shoulder impingement syndrome (SIS), you should follow up with your health care provider to see how your symptoms are progressing and check whether any aspect of treatment should change. After that, your follow-up will be directed by your doctor, physical therapist, or other health care provider. You may need additional guidance on how to resume normal activities. […] Once the pain has resolved and you regain full range of motion, strength, and shoulder stability, you can resume your usual activities. It’s best to start slow and gradually increase your activity level.

• #36 Shoulder Impingement (Care of the Young Athlete)

  https://www.westalabamapeds.com/sports/Shoulder-Impingement-Care-of-the-Young-Athlete

  2. Swelling inside the shoulder may worsen the pain and contribute to further injury. […] 3. Pain may be reduced by limiting activities or changing technique for painful activities. […] Proper posture is very importantchest out and shoulders back. These exercises strengthen parts of the body that help with posture and holding the shoulder bones in the proper position. […] Strength in the legs, hips, and trunk is crucial for maximizing arm strength and power with throwing or tennis. This part of rehabilitation can usually take place while shoulder pain is subsiding. […] Continue with maintenance exercises that have been prescribed and any corrections in technique or training regimens that helped with recovery. Include exercises that help prevent the strength imbalances that occur with repetitive overhead activity and contribute to injury. Athletes should continue select important exercises after therapy. These are typically not as extensive or time-consuming as the rehabilitation program.

• #37 Shoulder Impingement (Rotator Cuff Tendinitis)

  https://my.clevelandclinic.org/health/diseases/shoulder-impingement-rotator-cuff-tendinitis

  Most people with shoulder impingement start feeling better a few weeks after they start treatment. […] The best way to prevent shoulder impingement is to avoid overusing your shoulders: Stop exercising or physical activities as soon as you feel pain. […] Visit a healthcare provider as soon as you notice symptoms like pain, swelling or a decreased range of motion in your shoulder. […] Anything that irritates your rotator cuff and the tissue in your shoulder joint can cause shoulder impingement.

• #38 Shoulder Impingement Syndrome | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/shoulder-impingement-syndrome

  To facilitate healing, patients usually use a sling for the first one to two weeks after surgery. During that time, they shouldn’t drive. After this period, they begin a physical therapy program, focusing first on regaining passive range of motion and later on active range of motion. Between six and eight weeks after surgery, patients can progress to strengthening exercises, and a full return to activities is generally achieved three to four months after surgery.

• #39 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  Patients with stage II impingement may require a formal physical therapy program. Isometric stretches are useful in restoring range of motion. Isotonic (fixed-weight) exercises are preferable to variable weight exercises. […] Therapeutic injections (lidocaine plus a corticosteroid) are useful both because they are therapeutic and also because they can help the physician differentiate impingement from other problems. Indications for therapeutic injections include the following: Rotator cuff impingement that does not improve with conservative treatment, including NSAIDs and physical therapy. […] Not all cuff tears diagnosed clinically, or by arthography or MRI require surgical repair. A rotator cuff tear is not, in itself, an indication for surgery. […] Most older patients with impingement and rotator cuff tears actually do well without surgery. However, surgery might be considered in a patient who has failed to improve after six months of conservative treatment or in a patient less than 60 years of age with a debilitating tear that impairs function.

• #40 Shoulder Impingement: Symptoms, Causes, Treatment, and Exercises

  https://www.healthline.com/health/shoulder-impingement

  If other treatments don’t seem to work, you may need surgery to widen the space around your rotator cuff. This allows it to move freely without catching or rubbing on your bone. […] Following any type of shoulder surgery, you may need to briefly wear an arm sling. Your orthopedic surgeon will determine when you can remove the sling. […] During your recovery from shoulder impingement, you should avoid any activities that involve throwing, especially with your arms overhead, such as tennis, baseball, and softball. You should also avoid certain types of weightlifting, such as overhead presses or pull downs. […] While it’s important to rest your shoulder, you can do some light exercising to strengthen your rotator cuff and stretch the muscles in your arm, shoulder, and chest. […] Most people make a full recovery within a few months. In many cases, you’ll just need some rest and physical therapy. If those don’t provide relief, you may need surgery, which can add a few months to your recovery time.

• #41 Shoulder Impingement Syndrome | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/shoulder-impingement-syndrome.html

  Several forms of shoulder impingement syndrome have been described, however the classic and most common form will be reviewed here. This refers to a pinching or abrasion of the superior aspect (top) of the rotator cuff underneath the roof of the shoulder joint (the acromion process). […] Treatment for traditional shoulder impingement syndrome of the shoulder is with a dedicated physical therapy program to stabilize the shoulder muscles including the rotator cuff and the scapular stabilizing muscles (shoulder blade stabilizers). This is augmented with anti-inflammatory medications of either the oral (pill) form or injections, or even both. If this is not successful, then surgery may be indicated. […] Surgery for traditional shoulder impingement syndrome is performed arthroscopically and allows for a rapid recovery with minimal restrictions after surgery. The procedure may include the removal of the excess bone from the underside of the acromion as well as any scar tissue and bursitis in the shoulder. Occasionally, if a partial tear is found in the rotator cuff, this will be stimulated to heal as well. Physical therapy is still utilized after the surgery to provide a safe and rapid return to function, protecting the shoulder and strengthening it evenly.

• #42 Shoulder Impingement | Symptoms, Tests & Diagnosis | Spire Healthcare

  https://www.spirehealthcare.com/conditions/shoulder-impingement/

  Shoulder impingement (or rotator cuff tendinopathy) is when tendons in your shoulder rub against surrounding soft tissue and bone causing pain. […] Make an appointment to see your doctor or a physiotherapist if your shoulder pain lasts more than a few weeks or is affecting your everyday life. […] Treatments for shoulder impingement will vary depending on how serious it is. […] A physiotherapist can advise you about simple shoulder exercises for shoulder impingement. These exercises will: Improve your pain, Improve your range of movement, Improve your shoulder posture, Strengthen your shoulder muscles. […] If these exercises worsen your pain or your pain doesn’t improve after a few weeks, see your GP or physiotherapist. […] You will usually need surgery. There are two main types of surgery: Shoulder arthroscopy and Subacromial decompression surgery. […] In most cases, shoulder impingement will hurt all the time, both at rest and with activity. However, to start, the pain may be mild. As the shoulder impingement worsens, your pain will increase and may feel worse at night.

• #43 Shoulder Impingement Syndrome – Shoulder Tendonitis – Little Rock, AR & North Little Rock, AR: Martin Orthopedics

  https://www.martinortho.care/contents/patient-education/shoulder-impingement-syndrome-shoulder-tendonitis

  Shoulder impingement syndrome is a painful condition in the shoulder. It occurs when the tendons in the shoulder are irritated, inflamed or degenerated from repetitive overhead motions or structural abnormalities in the shoulder. Shoulder impingement syndrome is treated with activity modification, medication, and therapy. When non-surgical options fail, surgical treatment may be used to relieve symptoms and restore function. […] Treatments for shoulder impingement syndrome include rest from the irritating activity and ice packs or medication for pain and inflammation. Cortisone injections are often used. Physical therapy is very often used to regain motion and strengthen weakened muscles, thereby decreasing pain. […] Surgery is recommended when non-operative treatments have provided minimal or no improvement of your symptoms. Surgery may be necessary to enlarge the space beneath the acromion to allow the tendons to glide freely, or to trim degenerated tendon. This can be accomplished with surgery to remove bone spurs and the undersurface of the acromion (acromioplasty), remove some of the bursa, and occasionally a small part of the clavicle. The surgery is typically performed arthroscopically.

• #44 Shoulder Impingement Syndrome – Shoulder Tendonitis – Little Rock, AR & North Little Rock, AR: Martin Orthopedics

  https://www.martinortho.care/contents/patient-education/shoulder-impingement-syndrome-shoulder-tendonitis

  Arthroscopic surgery usually leads to less pain in the early post operative period. It has a reduced risk of infection, less blood loss, and less pain and stiffness because only small incisions are used and less surrounding tissue is affected or exposed. The recovery process is different for everyone, but typically it takes several months to recover from surgery with participation in rehabilitation therapy. Your doctor will let you know what to expect.

• #45 Shoulder Impingement Rotator Cuff Tendinitis

  https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-impingementrotator-cuff-tendinitis/

  When nonsurgical treatment does not relieve pain, your doctor may recommend surgery. […] The goal of surgery is to create more space for the rotator cuff. […] After surgery, your arm may be placed in a sling for a short period of time. This allows for early healing. As soon as your comfort allows, your doctor will remove the sling so you can begin shoulder exercises and use of the arm.

• #46 Shoulder Impingement Syndrome | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/shoulder-impingement-syndrome

  To facilitate healing, patients usually use a sling for the first one to two weeks after surgery. During that time, they shouldn’t drive. After this period, they begin a physical therapy program, focusing first on regaining passive range of motion and later on active range of motion. Between six and eight weeks after surgery, patients can progress to strengthening exercises, and a full return to activities is generally achieved three to four months after surgery.

• #47 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  Treatment and recovery from shoulder impingement syndrome rely heavily on interprofessional healthcare interaction. […] Communication between the physical therapist and primary care clinician should occur on a routine basis to guide further imaging and treatment. […] Orthopedic nurses assist in assessment, provide patient education, and communicate changes in patient status to the orthopedist.

• #48 CE Activity | Shoulder Impingement Syndrome | Nurses

  https://www.statpearls.com/nurse/ce/activity/104029

  Shoulder impingement syndrome is a painful condition of the upper extremity resulting from a structural narrowing of the subacromial space. It is primarily diagnosed by history and physical examination. The mainstay of treatment involves identification early before the onset of degenerative changes, physical therapy exercises to strengthen the shoulder girdle, and pharmacologic interventions to decrease inflammation. This activity describes the evaluation and management of shoulder impingement syndrome and highlights the role of an interprofessional team in the care of patients with this condition. […] Describe the interprofessional team strategies for improving care coordination and communication to enhance the care patients with shoulder impingement syndrome and improve outcomes.

• #49 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  Treatment and recovery from shoulder impingement syndrome rely heavily on interprofessional healthcare interaction. […] Communication between the physical therapist and primary care clinician should occur on a routine basis to guide further imaging and treatment. […] Orthopedic nurses assist in assessment, provide patient education, and communicate changes in patient status to the orthopedist.

• #50 Shoulder Impingement Syndrome (Ambulatory Care)

  https://www.drugs.com/cg/shoulder-impingement-syndrome-ambulatory-care.html

  Shoulder impingement syndrome happens when the tendons or bursa become trapped between bones of your shoulder joint. You have pain when you reach over your head or lie on the shoulder while sleeping. You may also have pain when you move your arm out to the side or behind your body. […] Seek care immediately if: Your shoulder, arm, hand, or fingers turn bluish or pale, or feel cold or numb. Your pain gets worse, even after rest and medicine. You cannot move your fingers. […] Treatment may include: Rest will help your shoulder pain. Limit reaching above your shoulder’s height. Apply ice on your shoulder for 20 minutes 1 or 2 times in a day. Use an ice pack, or put crushed ice in a plastic bag. You may also use a bag of frozen peas or corn. Cover the bag with a towel. Ice decreases swelling and pain. Physical therapy will teach exercises to stretch and strengthen your shoulder. Exercises will also help decrease pain. Medicines may be given to relieve pain and swelling. Surgery may be needed if your rotator cuff is torn or other treatments do not work. […] Follow up with your doctor and physical therapist as directed: Write down your questions so you remember to ask them during your visits.

• #51 Optimal management of shoulder impingement syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3945046/

  The goals in this phase are to normalize motion, diminish pain and inflammation, reestablish baseline dynamic stability, correct postural adaptations, and educate the patient in activity modification and avoidance. One of the primary goals in this phase is to diminish the patients pain and inflammation. […] The patient may have a decrease in active range of motion (ROM) with either a spasm or painful end feel on initial presentation. The patient should be educated to avoid/minimize activities in which the arm is raised above shoulder height to avoid motions that create impingement. […] During the acute phase of rehabilitation, it is important for the clinician to normalize motion. This is achieved through the use of AAROM, passive ROM exercises, and manual techniques. […] Strengthening exercises are initiated in the early phase of rehabilitation with the primary intent of restoring muscle balance/ratios and retarding muscle atrophy.

• #52 Optimal management of shoulder impingement syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3945046/

  The goals in this phase are to normalize motion, diminish pain and inflammation, reestablish baseline dynamic stability, correct postural adaptations, and educate the patient in activity modification and avoidance. One of the primary goals in this phase is to diminish the patients pain and inflammation. […] The patient may have a decrease in active range of motion (ROM) with either a spasm or painful end feel on initial presentation. The patient should be educated to avoid/minimize activities in which the arm is raised above shoulder height to avoid motions that create impingement. […] During the acute phase of rehabilitation, it is important for the clinician to normalize motion. This is achieved through the use of AAROM, passive ROM exercises, and manual techniques. […] Strengthening exercises are initiated in the early phase of rehabilitation with the primary intent of restoring muscle balance/ratios and retarding muscle atrophy.

• #53 Patient Education | Concord Orthopaedics

  https://www.concordortho.com/patient-resources/patient-education/topic/258a9c64e3fd197984c159d59e19e7d0

  Doctors usually start by prescribing nonsurgical treatment. You may be prescribed anti-inflammatory medications such as aspirin or ibuprofen. Resting the sore joint and putting ice on it can also ease pain and inflammation. If the pain doesn’t go away, an injection of cortisone into the joint may help. Cortisone is a strong medication that decreases inflammation and reduces pain. Cortisone’s effects are temporary, but it can give very effective relief for up to several months. […] Your doctor may also prescribe sessions with a physical or occupational therapist. Your therapist will use various treatments to calm inflammation, including heat and ice. Therapists use hands-on treatments and stretching to help restore full shoulder range of motion. Improving strength and coordination in the rotator cuff and shoulder blade muscles lets the humerus move in the socket without pinching the tendons or bursa under the acromion. You may need therapy treatments for four to six weeks before you get full shoulder motion and function back.

• #54 Optimal management of shoulder impingement syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3945046/

  Before the initiation of the therapy program, it is imperative to perform a complete and thorough evaluation. This will enable the clinician to establish an accurate diagnosis, identify all causative factors, and determine the involved structure or structures. This will allow the rehabilitation specialist to implement an individualized treatment program to address these factors and prioritize the treatment goals. The primary emphasis of the treatment program is to reduce the mechanical irritation to the rotator cuff and promote a restoration in tendon vascularity that can result from muscle guarding, mechanical compression, and abnormal shoulder mechanics. […] The nonoperative rehabilitation program outlined in this article for the treatment of shoulder impingement is a multiphased approach focused on a return to prior level of function via a systematic process. This treatment program is outlined in Table 4 and consists of four phases that are a gradual progression of exercises and implied stresses that increase and become more demanding than those of the previous phase of treatment. The effectiveness of the treatment program is based on the identification of the underlying causative factor or factors and the individualized program designed to address this condition.

• #55 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  Treatment and recovery from shoulder impingement syndrome rely heavily on interprofessional healthcare interaction. […] Communication between the physical therapist and primary care clinician should occur on a routine basis to guide further imaging and treatment. […] Orthopedic nurses assist in assessment, provide patient education, and communicate changes in patient status to the orthopedist.

• #56 Shoulder Impingement (Rotator Cuff Tendinitis)

  https://my.clevelandclinic.org/health/diseases/shoulder-impingement-rotator-cuff-tendinitis

  Most people with shoulder impingement start feeling better a few weeks after they start treatment. […] The best way to prevent shoulder impingement is to avoid overusing your shoulders: Stop exercising or physical activities as soon as you feel pain. […] Visit a healthcare provider as soon as you notice symptoms like pain, swelling or a decreased range of motion in your shoulder. […] Anything that irritates your rotator cuff and the tissue in your shoulder joint can cause shoulder impingement.

• #57 Shoulder Impingement Syndrome: Symptoms & Treatment | HSS

  https://www.hss.edu/condition-list_shoulder-impingement.asp

  The treatment for subacromial impingement depends on the severity of the condition. […] Mild cases may be treated by patient education, activity modification, resting and icing the shoulder, taking over-the-counter pain medication such as nonsteroidal anti-inflammatory drugs (NSAIDs), and undergoing physical therapy. […] If these methods fail and/or in some more severe cases, injections of corticosteroids, platelet-rich plasma (PRP) or other agents may reduce inflammation and pain and improve function. […] There are a number of things you can do to help prevent shoulder impingement, including warming up before exercising, stretching after exercising, avoiding activities that put stress on your shoulders, maintaining a healthy weight, maintaining good posture and, for office workers, proper desk ergonomics and good movement patterns, strengthening the muscles around your shoulder, using proper weight training techniques to balance muscles.

• #58 Shoulder Impingement Treatment in Wake County | Raleigh Ortho

  https://www.raleighortho.com/specialties/sports-medicine/shoulder-impingement/

  If your shoulder pain does not subside with non-surgical methods, surgery may be necessary. […] Recovery time for shoulder impingement depends on the severity of the injury and the treatment path recommended by your doctor. […] Preventing shoulder impingement starts with proper warm-up routines, strength training, and flexibility exercises. […] Our sports medicine specialists will take the time to understand your situation, helping discover the root cause of your injury and the best course of action to alleviate pain and prevent future complications.

• #59 Shoulder Impingement (Rotator Cuff Tendinitis)

  https://my.clevelandclinic.org/health/diseases/shoulder-impingement-rotator-cuff-tendinitis

  Most people with shoulder impingement start feeling better a few weeks after they start treatment. […] The best way to prevent shoulder impingement is to avoid overusing your shoulders: Stop exercising or physical activities as soon as you feel pain. […] Visit a healthcare provider as soon as you notice symptoms like pain, swelling or a decreased range of motion in your shoulder. […] Anything that irritates your rotator cuff and the tissue in your shoulder joint can cause shoulder impingement.

• #60 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0215/p667.html

  Patients with stage II impingement may require a formal physical therapy program. Isometric stretches are useful in restoring range of motion. Isotonic (fixed-weight) exercises are preferable to variable weight exercises. […] Therapeutic injections (lidocaine plus a corticosteroid) are useful both because they are therapeutic and also because they can help the physician differentiate impingement from other problems. Indications for therapeutic injections include the following: Rotator cuff impingement that does not improve with conservative treatment, including NSAIDs and physical therapy. […] Not all cuff tears diagnosed clinically, or by arthography or MRI require surgical repair. A rotator cuff tear is not, in itself, an indication for surgery. […] Most older patients with impingement and rotator cuff tears actually do well without surgery. However, surgery might be considered in a patient who has failed to improve after six months of conservative treatment or in a patient less than 60 years of age with a debilitating tear that impairs function.

• #61 Shoulder Impingement Rotator Cuff Tendinitis

  https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-impingementrotator-cuff-tendinitis/

  Shoulder pain is one of the most common physical complaints affecting people of all ages and for a variety of reasons. The rotator cuff tendons and muscles, which are responsible for moving the shoulder, are a frequent cause of shoulder pain. […] The goal of treatment is to reduce pain and restore function. In planning your treatment, your doctor will consider your age, activity level, and general health. […] In most cases, initial treatment is nonsurgical. Many patients experience a gradual improvement and return to function, although it may take several weeks to months for complete recovery. […] A physical therapist will focus on restoring motion to your shoulder. Stretching exercises to improve motion are very helpful. […] If rest, medications, and physical therapy do not help your pain, an injection of a local anesthetic and steroid may be helpful.

• #62 Shoulder Impingement | Florida Orthopaedic Institute

  https://www.floridaortho.com/specialties/shoulder/impingement-syndrome-shoulder/

  Regardless of your case’s severity, you will likely need to undergo a course of physical therapy. PT, commonly abbreviated and referred to, is a collection of exercises trained physical therapists design specifically for you with your doctor’s input. PT exercises are geared towards restrengthening your shoulder and recapturing lost motion ranges. […] Researchers have found that non-surgical treatments typically produce favorable results in as many as 60% of those diagnosed with shoulder impingement syndrome. Recovery typically occurs over a period of weeks to months. Surgical procedures are also usually very effective. Recovery times will vary depending on many underlying factors.

• #63 Patient education: Shoulder impingement syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/shoulder-impingement-syndrome-beyond-the-basics/print

  Health care providers sometimes suggest injections of medications called glucocorticoids, known commonly as „steroids,” directly into the shoulder, beneath a bone called the acromion. Steroids help to relieve inflammation and pain, and consequently make it easier for you to perform physical therapy effectively. […] Two to four weeks after starting treatment for shoulder impingement syndrome (SIS), you should follow up with your health care provider to see how your symptoms are progressing and check whether any aspect of treatment should change. After that, your follow-up will be directed by your doctor, physical therapist, or other health care provider. You may need additional guidance on how to resume normal activities. […] Once the pain has resolved and you regain full range of motion, strength, and shoulder stability, you can resume your usual activities. It’s best to start slow and gradually increase your activity level.

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