Written by Dr Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho. ), FAMS (Singapore)
Table of Contents
What Is Shoulder Impingement
Shoulder impingement occurs when the shoulder blade's motion compresses the rotator cuff tendons or bursa, leading to irritation and inflammation. The condition is often a result of repetitive arm movements, structural peculiarities, or the progressive wear associated with ageing. It can significantly affect one's quality of life by limiting the range of motion and causing persistent discomfort.
Shoulder impingement syndrome, a common condition characterised by the compression of the rotator cuff tendons and bursa by the shoulder blade, results in irritation, inflammation, and discomfort. Often caused by repetitive arm movements, structural anomalies, or age-related wear and tear, it restricts the shoulder's range of motion and significantly impacts quality of life. Seeking a shoulder impingement specialist in Singapore to address the condition early is crucial to manage pain, preserve functionality, and prevent further joint deterioration.
Symptoms Of Shoulder Impingement
Individuals with shoulder impingement typically experience:
- Persistent pain in the shoulder area, especially when lifting the arm
- Limited range of motion
- Discomfort when performing activities overhead
- Swelling and tenderness in the shoulder area
- Occasional 'catching' or 'locking' sensation during arm movement
Diagnosing Shoulder Impingement
Diagnosis of shoulder impingement typically encompasses the following:
- Medical History: A review of symptoms, activity levels, occupational risks, and any history of shoulder issues.
- Physical Examination: Assessment of pain, range of motion, and strength in the shoulder. Specific tests may be performed to replicate the impingement symptoms.
- Imaging Tests: X-rays can identify bone spurs or changes in the bone structure, while MRI scans provide detailed views of soft tissues, including tendons and the bursa, aiding in confirming the diagnosis.
- Ultrasound: May be used to assess the condition of tendons and the bursa, especially in dynamic shoulder movements.
Early diagnosis and intervention by a shoulder impingement specialist is crucial in formulating an effective treatment plan and preventing further deterioration of shoulder function due to the condition.
Non-surgical Shoulder Impingement Treatment
Initial treatment strategies often focus on non-invasive methods such as:
- Physical therapy to strengthen the shoulder muscles and improve flexibility.
- Medications such as non-steroidal anti-inflammatory drugs help in managing pain and reducing inflammation.
- Corticosteroid injections may be considered to provide immediate relief from inflammation and discomfort.
- Lifestyle and activity modifications are advised to alleviate symptoms and prevent further impingement.
Shoulder Impingement Surgery
If conservative treatments are insufficient to address the condition, surgical intervention may be necessary. The option to proceed with surgery is made after a comprehensive evaluation of the patient's condition by a specialist, considering factors like the severity of impingement, the patient's activity level, and their response to previous treatment attempts. Ultimately, the goal of surgical intervention is to enable patients to return to their daily activities and sports with minimal or no discomfort, ensuring a high quality of life post-recovery.
Shoulder impingement surgery is typically executed using arthroscopic techniques, a minimally invasive method that allows for precise correction with less discomfort and a quicker recovery period compared to open surgery. This surgical procedure focuses on meticulously removing or modifying parts of the shoulder bone, specifically the acromion, to widen the space available for the rotator cuff tendons, effectively reducing the risk of compression and irritation.
Additionally, shoulder impingement surgery addresses any accompanying issues within the shoulder joint, such as repairing torn rotator cuff tendons that contribute to impingement symptoms or excising inflamed bursae that exacerbate pain and restrict movement. By targeting the structural causes of impingement and repairing tendon damage, shoulder impingement surgery aims to significantly reduce pain, improve the range of motion, and restore overall shoulder functionality.
Recovery Period For Shoulder Impingement Surgery
The recovery period after undergoing shoulder impingement surgery is a gradual process that can vary significantly in duration, typically ranging from a few weeks to several months, depending on the complexity of the surgery and the individual's overall health. The initial phase of recovery is marked by a period of rest, crucial for the healing of the surgical site. This phase, often spanning a few weeks, is essential for ensuring that the structures within the shoulder begin to mend without the strain of regular activities.
Following this period of rest after a shoulder impingement surgery, patients transition into a carefully designed rehabilitation program. This program, tailored to meet the specific needs and recovery goals of each patient, is instrumental in the recovery process. It focuses on a series of exercises aimed at gradually rebuilding the strength of the shoulder muscles, enhancing flexibility, and restoring the full range of motion. The rehabilitation program plays a pivotal role not only in recovery but also in preventing future injuries by strengthening the shoulder joint.
Throughout the recovery period, patients work closely with physical therapists and healthcare professionals to monitor progress and adjust the program as needed to ensure a comprehensive recovery. This approach ensures that each step of the rehabilitation process contributes towards achieving optimal shoulder function and pain relief, allowing patients to return to their daily activities, sports, and work swiftly.
Dr Gowreeson Thevendran
Dr Gowreeson Thevendran is an orthopaedic surgeon in Singapore that specialises in orthopaedics and trauma surgery. His particular skill set is minimally invasive surgical techniques to treat foot, ankle, knee, and hip/thigh conditions. He pursued fellowship training for sports surgery at Chelsea & Westminster Hospital, UK and complex trauma and deformity correction at Royal Liverpool University Hospital, UK. He also continues to serve the Orthopaedic Department at Tan Tock Seng Hospital as a visiting consultant.
If you are suffering from pain or impingement in any other joints such as hips or shoulders, you can consult our qualified orthopaedic surgeon who will thoroughly assess your condition and provide you with the right intervention methods.
Furthermore, our orthopaedic surgeon or sports injury doctor in Singapore can also assist you with other painful conditions related to your foot or ankle through appropriate procedures which may include bunion surgery, treatment for plantar fasciitis and other surgeries.
Qualifications
- Bachelor of Medicine and Surgery, University of Bristol, England
- Fellow of the Royal College of Surgeons, Edinburgh
- Diplomate Faculty of Sports and Exercise Medicine, Royal College of Surgeons Edinburgh
- Fellow of the Academy of Medicine, Singapore
Awards
- SICOT PIONEER Founders Award 2020
- 2015 European Foot & Ankle Society ‘Best Podium Presentation’ Award
- 2013 Singapore Orthopaedic Association Junior Travelling Fellowship
- 2012 NHG Critical Talent Special Recognition Award
- 1998 Enid Lindt Prize in Clinical Surgery
- 1995 Public Services Department Full Medical scholarship
Shoulder Impingement Surgery Frequently Asked Questions
Shoulder impingement can be caused by various factors, commonly resulting from repetitive overhead activities common in certain sports or jobs, which can lead to irritation of the rotator cuff tendons. Structural factors, such as a naturally narrow subacromial space, can also predispose individuals to shoulder impingement. Additionally, the natural ageing process can cause wear and tear on shoulder tendons and muscles, increasing the risk of the condition.
Orthofoot MD is on the panels of different health insurance plans and also accepts Medisave. Patients seeking shoulder impingement surgery in Singapore should inquire with both their insurance provider and the clinic regarding their eligibility for insurance and Medisave coverage. While multiple treatments may be covered, the extent of coverage for rotator cuff surgery may vary and is subject to verification by the clinic.
If shoulder impingement is left untreated, it can lead to a worsening of symptoms and it may lead to a progressive decline in shoulder function. You might experience discomfort and limited mobility in the initial stages. Over time, these issues can intensify, potentially leading to chronic pain, increased inflammation, and a significant reduction in the range of motion. Early intervention can prevent these complications. Do consult a healthcare professional if you suspect a shoulder impingement injury.
While generally safe, shoulder impingement surgery may also present risks such as infection, bleeding, nerve or vessel damage, anaesthesia reactions, and post-operative stiffness or pain. There's also a possibility of recurrent shoulder impingement symptoms. Consulting with your healthcare provider and closely following post-surgery care instructions are crucial for minimising these risks and ensuring a successful recovery.
Clinic Location
OrthofootMD@Novena
- Mount Elizabeth Novena
38 Irrawaddy Road #05-42 Mount Elizabeth Novena Specialist Centre Singapore 329563
OrthofootMD@Mount Alvernia Hospital
- (Mount Alvernia Hospital)
820 Thomson Road #01-01/02 Mount Alvernia Medical Centre A Singapore 574623