Impingment shoulder joint syndrome

Shoulder joint includes shoulder blade, shoulder bones and collarbone, rotational cuff - supraclavicular, subclavian, small round and submapular muscles. When the arm rises, the cuff presses the bone head to the cavity of the scapula.

Scabbard process - acromion - forms the upper part of the joint. The joint bag is placed between the scapula and the tendons of the cuff.

It protects the appendix and tendons from friction.

What is impingement syndrome

There is usually such a distance between the acromion and the cuffrotation so that the tendons freely pass under it. But every time you raise your arm, you can feel the pressure of the tendons and the bag of the joint.

This phenomenon is called impingment syndrome of the shoulder joint.

Often, the syndrome occurs when the cuff tendon is affected. The appearance of a disorder provokes conditions that cause a decrease in the distance between the acromion and tendons. Often its cause is the bone spurs of the clavic joint.

In some cases, the gap is narrowed due to an enlarged scapula, tilting it down.

Subacromial impingement of shoulder joint syndrome - affection of structures of located near subacromial sac, manifested by impaired movement of the shoulder joint.

This lesion is a common cause of shoulder pain in adults. Pain is the result of the pressure of the scapula on the joint capsule when the arm is raised.

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Causes that cause

Syndrome The disease has a characteristic cause:

• neurodynamic changes in tendons due to cervical osteochondrosis, spondylosis or displacement of vertebral joints;
• soft tissue damage due to cyclic or one-stage heavy loads;
• lesions, accompanied by tendon ruptures, hemorrhages;
• disease( infarction, angina pectoris, tuberculosis, diabetes, TBI, Parkinsonism);
• single operations( mastectomy).

Provoking factors:

• continuous cooling;
• congenital arthropathy.

In tissues with insufficient blood supply, foci of necrosis are formed, which subsequently become scarred and calcified, and also become inflamed.

Impingment shoulder syndrome is observed among young athletes and middle-aged people. Swimmers, volleyball players, and tennis players are most susceptible.

The risk of illness in people whose activity implies constant raising of hands is also high. Pain may also occur due to minor injury or for no particular reason.

Symptoms and signs

In the early stages of the complaint, patients suffer from dull pain in the shoulder, which increases with the rise of the arm, which does not allow them to fall asleep.

On the started stages the pain increases, the mobility of the joint decreases, a click is observed when the arm is lowered.

Weakness and difficulty in raising a limb can speak of a rupture of tendons.

Diagnostic techniques

Diagnosis with impingement syndrome is based on the analysis of lesion manifestations and the study.

Doctor will ask about the nature of your work, tk.the violation is very often associated with professional activities. X-rays of the joint can be used to determine the affected acromion or bone spurs.

If there is a suspicion of rupture of the rotation cuff during the examination, magnetic tomography will be required.

The arthrogram is assigned to detect cuff rupture. During the procedure, a special compound is inserted into the joint. The flow of it from the joint cavity confirms the rupture. In some cases, it is not clear what causes the pain.

The introduction of a local anesthetic into the bag of the joint helps to determine the source of the pain. If the pain disappears after the injection, it arises from bursitis or tendonitis. With pain, provoked by irritation of the nerves, this is not observed.

Treatment procedures

The main goal of the treatment is to neutralize the pain and restore the joint.

Begin treatment with conservative therapy.

It consists of the reception of non-steroidal medications( Voltaren), a gentle regimen for the affected limb, physiotherapy, massage. With severe pain, blockade with glucocorticoids( Diprospan) is used.

These drugs are extremely effective for neutralizing pain, relieving edema and inflammation. The action of glucocorticoids lasts several months. To restore mobility in the joint in an acute period exercises are useful.

As the pain subsides, strength exercises for the development of shoulder muscles are added to them. The course of conservative treatment is up to 6 weeks. During this period, many people have pain, normal joint work.

Surgery

If, after such a method of treatment, a person does not leave joint pain, the specialist may advise to perform the operation. The aim of the intervention is to increase the distance between the scapula and the rotator cuff.

The specialist removes bone spines that reduce the gap and affect the tendons.

Impedment of shoulder syndrome is often accompanied by osteoarthritis of the clavicular junction.

Therefore, interference with the syndrome is combined with an operation to neutralize the joint osteoarthritis. This procedure is called resection arthroplasty.

Its meaning is to relieve the pain that appears due to friction of the articular ends of the acromion and clavicle. Subsequently, connective tissue fills the distance between the appendage and clavicle, forming a false joint.

In some cases, arthroscopic intervention is performed. The arthroscope is inserted into the joint through the incision. The contents of the joint can be seen on the monitor. In this way, the doctor can detect an acromion site that reduces the gap.

Through another incision, special tools are introduced, by which this part of the scapula is removed.

Rehabilitation after operation

A competently performed procedure enables you to start rehabilitation quickly enough to anticipate complications and shorten the terms of recovery.

After the procedure, the arm is immobilized in the allotted position for several weeks via the tire. This reduces the risk of a rupture, creates conditions for the healing of the tendon. The duration of immobilization is determined by the doctor who performed the operation.

Exercises are aimed at normalizing the volume of movements in the shoulder, anticipating the appearance of contractures, increasing the endurance of the muscles of the shoulder girdle. Exercises are chosen individually and performed under the supervision of experienced instructors. Part of the exercises prescribed for the patient to perform at home.

Physiotherapy includes:

• magnetotherapy;
• ultrasound with the introduction of drugs;
• electrotherapy.
• massage.

Possible complications of

Basically, timely treatment increases the chances of recovery. It should be borne in mind that a neglected disorder is more difficult to treat and often causes serious complications.

Paralyzes, attenuations of arbitrary movements and limitedness worsen the prognosis and can lead to disability.

Preventative measures

The main preventive measures:

• elimination of permanent injuries of the synovial bag;
• use of protective dressings for physical exertion;
• for minor damages - wound treatment with antiseptics, application of bactericidal dressings;
• timely treatment of infectious diseases.

Most people are cured without surgery, especially in the early stages. All patients should consult a specialist as early as possible. The success of treatment depends on the timing of its application.