Shoulder Impingement Specialist Treating Patients in Houston, TX

Shoulder impingement is the condition of inflammation of the tendons of the shoulder joint. It is one of the most common causes of pain in the adult shoulder. The shoulder is a ‘ball-and-socket’ joint. A ‘ball’ at the top of the upper arm bone, humerus, fits neatly into a ‘socket’, called the glenoid, which is part of the shoulder blade, scapula. Shoulder impingement is also called as swimmer’s shoulder, tennis shoulder, or rotator cuff tendinitis.

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    Shoulder Impingement


    Impingement results from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted. It is more likely to occur in young and middle aged people who engage in physical activities that require repeated overhead arm movements. The pain may be due to a “bursitis” or inflammation of the bursa overlying the rotator cuff or a “tendonitis” of the cuff itself. In some circumstances, a partial tear of the rotator cuff may cause impingement pain.


    Individuals with shoulder impingement may experience severe pain at rest and during activities, weakness of the arm and difficulty in raising the hand overhead.


    Diagnosis involves physical examination by the doctor where in the doctor checks for the possible range of movements with the affected shoulder. X-rays and MRI scans may be ordered to see the injury and inflammation.

    Conservative Treatment Options

    Shoulder impingement can be treated with rest, ice packs, anti-inflammatory drugs, and avoiding the activities involving the shoulder. Physical therapy may be advised to strengthen the muscles and steroid injections may be given if pain persists.

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    Arthroscopic surgery is recommended if the rotator cuff tendons are torn and to remove the bony spurs.

    We sometimes call shoulder impingement “swimmer’s shoulder,” but you don’t have to swim to experience it. Anyone who lifts their arms often or suffers an injury can have shoulder impingement. Fortunately, Dr. Gombera treats patients with any level of physical activity in their lives. He can suggest the right approach for athletes and non-athletes because of his experience with both kinds of patients.

    What Is Shoulder Impingement?

    Impingement is one of the most common causes of shoulder pain in adults. To understand why impingement hurts, you need to know the shoulder joint’s anatomy. We call the shoulder joint a “ball and socket” joint because the bones in the joint connect together like a ball and socket. The “ball” at the top of your arm bone fits into the “socket,” or glenoid, in your shoulder blade.

    A network of tendons, ligaments and cartilage cushion these bones and help them move properly. Your rotator cuff consists of muscles and tendons that surround the shoulder joint and let you lift your arm. It lies between your arm bone and the bone on the top of your shoulder.

    When you have shoulder impingement, the top of the shoulder (acromion) puts pressure on your rotator cuff. Injury, inflammation or infection causes the tissue between the top of the shoulder and the arm bone to swell. This swelling results in the rotator cuff and the top of the shoulder pressing against each other. The pressure damages the rotator cuff and creates more inflammation. If shoulder impingement does not get treatment, serious issues like a rotator cuff tear can occur.

    How Does Shoulder Impingement Pain Feel?

    Shoulder impingement creates the following types of pain and stiffness:

    • Pain during throwing motions and other kinds of dynamic movement
    • Shoulder pain that happens when you lift your arm, move it out to the side or move it beside the body
    • Discomfort when you try to sleep on the affected shoulder’s side
    • Restricted movement and weakness when you reach above your head, to the side or behind the body


    Why Does a Patient Develop Shoulder Impingement?

    Multiple factors can cause shoulder impingement, including:

    • Jobs or sports that involve repetitive overhead movements, including golfing, swimming and heavy labor
    • An injury that results in shoulder compression
    • Bone abnormalities in the acromion/top of the shoulder
    • Osteoarthritis
    • Poor muscle strength in the rotator cuff and shoulder blade
    • Thickened ligaments
    • Tightened soft tissue


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    What Methods Does Dr. Gombera Use for Diagnosis?

    As you can see, shoulder impingement has many possible causes. An orthopedic specialist like Dr. Gombera needs to use multiple diagnosis strategies to figure out your problem. He’ll first review your medical history and conduct a physical examination. During the examination, he’ll check your shoulder’s range of movement.

    You may need to receive an X-ray or MRI scan so that the doctor can see the bones and cartilage in the joint. In some cases, he might inject a painkiller under your acromion. If this painkiller works, it means that the area is the source of your pain.

    How Does Dr. Gombera Approach Swimmer’s Shoulder Treatment?

    If you worry about needing surgery, remember that Dr. Gombera always tries to use non-surgical methods as the first line of treatment. In many cases, your body will do the best job at shoulder impingement repair — it just needs a little help from you and your doctor. Dr. Gombera often recommends the following conservative treatments:

    • Physical therapy to strengthen the muscles
    • Ice to reduce pain and swelling
    • Over-the-counter painkillers or steroid injections to relieve pain

    When non-surgical treatments don’t work, you may need a shoulder impingement surgery like an arthroscopy. In this case, the body cannot repair the impingement and requires medical intervention. Arthroscopy involves a small scope with a light and camera. Dr. Gombera uses this arthroscope to look at the shoulder without making a large incision. He can then address the problem causing pain in your shoulder by inserting thin instruments into more small incisions. During the arthroscopy, he can remove damaged tissue, get rid of bone spurs on the acromion and repair torn tendons.

    What Should I Expect After Shoulder Arthroscopy?

    After your shoulder arthroscopy procedure, you’ll get a checklist that instructs you on how to take care of your shoulder. Between your surgery and the follow-up visit, you need to wear a sling, protect your incisions and begin physical therapy.

    Let Dr. Gombera Find a Solution for Your Shoulder Pain

    Mufaddal Gombera, MD helps patients in Houston, TX get back to doing what they love. If you believe you have shoulder impingement or another shoulder, hip or knee issue, he can help. Schedule an appointment using our online tool or call (713) 794-3457 to speak with one of our office staff members.

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    Always has a smile on his face, extensive knowledge in orthopedics and a conservative approach to treatment. Would highly recommend.

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