The shoulder joint consists of three seperate bones, the humerus or upper arm bone, collar bone or clavicle and the shoulder blade or scapula. All of these bones make up the shoulder. Until I got a shoulder injury, I thought of my shoulder blade as a simple triangle of bone that sat on my back and stuck out if I pushed my elbows forward. I had not really given any thought to its design or purpose.
Actually, it is quite a complex design. At the top outer corner it has a cup of bone called the glenoid which forms the ball of the shoulder ball and socket joint. The shoulder blade also attaches to the collar bone at the top. This part of the shoulder blade is a piece of bone that curves over at the top called the Acromion.
In addition to the the bones of the joint there are seventeen different muscles which work the shoulder as well as ligaments and cartilage that all go to make up and hold together this complex joint.
The rotator cuff is a group of four muscles that all run from the scapula to the head of the humerus, surrounding the joint in a cuff of muscle . They all pull the ball at the head of the upper arm bone into the socket of the shoulder joint. Because the socket of this joint is very shallow these muscles are essential to hold the arm in place and stabilize the joint. Without them our shoulders could become easily dislocated.
One of these muscles, the supraspinatus runs through a channel of bone in the hook of the acromion before attaching to the upper arm bone. Imagine a thin tendon running through a channel of bone. If the channel narrows or the tendon gets inflamed the tendon can rub on the bone which will start to damage the tendon leaving it likely to tear or fray. Think of it like an old rope being rubbed against a sharp edge, after time the rope would begin to fray and if left long enough could actually snap.
The causes of rotator cuff impingement are similar to other injuries. Any strain or injury to this particular tendon, that causes swelling, can trigger a rotator cuff impingement. Arthritis can cause the tunnel of bone to narrow and as we age some of us actually grow bony spurs on the acromion that will narrow the channel and cause problems.
The symptoms of an impingement are pain in the shoulder especially when raising the arm above shoulder height or reaching up or out for something coupled with difficulty sleeping at night. A simple test that your doctor might do for a rotator cuff impingement is to get you to straighten your arm with the palm facing away from your body and then to raise it up. If this causes pain then you almost certainly have a rotator cuff impingement.
Don't ignore a rotator cuff impingement as this can cause more serious problems. Therapy starts with rest and anti-inflammatory drugs to reduce the inflammation. Do Make sure that you avoid any overhead movements. If you work at something like painting or plastering you may need to modify how you work to do away with these movements. Once the muscles are rested and have started to get better you can begin therapy to build up the rotator cuff to help avoid further problems.
In persistent cases or if the bone has changed shape then you are almost certainly looking at coreective surgery to correct things. This will involve keyhole surgery called a sub-acromial decompression where the surgeon shaves away a small piece of bone to free up the trapped tendon.
Most rotator cuff impingements can be solved without surgery but it is vital to take this injury seriously and let it rest, avoiding overhead movements. The pain you feel is telling you that more damage is being done so listen to your body and let it heal.
Having torn my rotator cuff and ending up with a shoulder impingement I started to research shoulders and the rotator cuff to better understand my own injury. Check out my blog for more useful information
Nick Bryant lives in Shropshire in the UK with his wife and two young children where he is a director in their family recruitment business.His hobbies and interests tend to be family orientated and focussed on the outdoors and sporting activities.He is the proud owner of a vintage VW camper and he and his family spend a great deal of their spare time at the coast camping, body-boarding and surfing in the summer months.He is also a keen golfer. He writes on a number of subjects around personal health and well being and has recently started a blog at http://www.myrotatorcuffcure.blogspot.com.
Disclaimer: All information on this site is provided for informational purposes only! By no means is any
information presented herein intended to substitute for the advice provided to you by any health care or other professional
or organization.
tweet this!