The concept of shoulder impingement syndrome was first attributed to Charles Neer when he published a paper in 1972. However, the term shoulder impingement itself now belongs to a group of terms that describes pain in the shoulder. This pain in the shoulder region results in a mechanical ‘impingement’ of the rotator cuff as it passes under the shoulder joint.
Rotator cuff disorders are considered to be the most common cause of shoulder pain, which affects 1 in 3 adults. If left untreated, rotator cuff impingement may proceed to partial or complete rotator cuff tendon rupture or tear.
Depending on both the individual and the stage of the condition, there are a variety of treatment options available; however a patient specific treatment plan should always be implemented.
Neer outlined 3 stages of shoulder impingement:
- Stage 1: Inflammation and swelling typically occurring in younger athletes. Usually reversible with conservative treatment.
- Stage 2: Inflammation, swelling, and more irreversible than stage 1. Ages affected usually 25-40
- Stage 3: Affects usually 40+. Mechanical disruption of the rotator cuff and typically either partially to completely torn in which surgery is suggested.
In the most cases, an initial conservative approach usually suggested to help with the resolution of symptoms, which usually includes therapeutic exercise (or PT) and corticosteroid injections. However in certain cases, various surgical options are available. If left untreated rotator cuff impingement may proceed to partial or complete rotator cuff tendon rupture.
Jessica Thomas MS, ATC, CHC
