Shoulder impingement, also known as subacromial impingement or swimmer’s shoulder, is caused when the tendons of the rotator cuff become trapped as they pass through the narrow bony channel known as the subacromial space. This little tunnel in the shoulder normally allows those tendons to slide back and forth with no restriction as you move your arm. However, repetitive use of the shoulder, more specifically repetitive overhead movement (like that of freestyle swimming strokes) can cause that tunnel to narrow, putting pressure on the tendons. There are two main reasons this impingement can happen; the physical space within that tunnel narrows due to tightness of surrounding muscles pushing the structures closer together, or the rotator cuff becomes damaged in some way leading to inflammation and swelling, making the tendon a bit larger, and therefore harder to fit within the space. One can also lead to the other, as well as cause other inflammatory issues within the shoulder, like bursitis.
Symptoms usually include pain with overhead use of the arm, like reaching into upper cabinets or brushing your hair, as well as weakness of the shoulder muscles, making it difficult to raise your arm. While shoulder impingement itself may seem like a relatively small issue if your symptoms are minor, the continued inflammation in the area can lead to further damage, weakening the rotator cuff, making you more likely to experience a rotator cuff tear and other shoulder injuries. If you’re experiencing this kind of pain and restriction, it’s important to get a checkup with your doctor, and depending on their specific training, potentially a referral to an orthopedic specialist. Either may order an x-ray to rule out arthritis, bone spurs, and other issues, as well as look at the health of the bone and joint.
The most common treatment for shoulder impingement includes ant-inflammatory medications as well as physical therapy and massage therapy to decrease the inflammation and open that subacromial space, allowing the tendon to move more freely. Along with the manual work of massage to loosen the restrictions within the shoulder, exercises and stretches with a physical therapist and at home will help to re-educate your muscles to keep that space open as it should be.