Shoulder Impingement The four muscles that make up the rotator cuff attach to the head of the humerus. These muscles stabilize the shoulder and work together to lift and internally and externally rotate the shoulder. The sites of attachment for these muscles sit behind the acromion process of the scapula. As the arm is lifted, the acromion process can rub the rotator cuff muscles and this cause pain in the shoulder. Shoulder impingement can be a result of overhead sports, such as baseball, swimming, and tennis. It can also result from activities of daily living such as painting and housework. Symptoms: Minor pain that is present both with activity and at rest Pain radiating from the front of the shoulder to the side of the arm Sudden pain with lifting and reaching movements Athletes in overhead sports may have pain when throwing or serving a tennis ball Swelling Stiffness Diagnosis: Your physician will evaluate your injury by taking a complete medical history, including mechanism of injury, prior injuries and symptoms. Your physician will perform a complete physical examination of the shoulder, checking for tenderness and pain. Your physician may also order an x-ray. Treatment: Avoid strenuous activity for your shoulder Use ice for 20 minutes on with 40 minutes off throughout the day for the first 2-3 days, and then switch to heat. You can use heat for 20 minutes one to several times a day. Physical therapy - your physical therapist will have you perform a series of exercises to strengthen the rotator cuff muscles Take an anti-inflammatory or pain medication as prescribed by your physician. An injection of a corticosteroid to reduce inflammation. Surgery: Your surgeon may perform an arthroscopic surgery in which they insert a tube into the shoulder. This tube has a light and camera on the end and makes it easier for the doctor to see and repair the affected area. They repair the impingement by shaving down the bone. Physical therapy will be prescribed after surgery.