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Impingement, Subacromial Bursitis and Rotator Cuff Tendinitis, Sports Medicine

Andrew Cheung, DO and Mark E. Lavallee, MD, CSCS, FACSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Repetitive shoulder activity causes breakdown in the rotator cuff muscles from tensile overload and results in tendinopathy.

  • Weakness in the rotator cuff muscles (supraspinatus, infra...

DIAGNOSIS

HISTORY

  • Rule out cervical spine disease, neck pain.

  • Symptoms: weakness, crepitation, numbness, “slipped out,” night pain, dead arm

  • Exacerbation: Pain presents more at rest or with activity.

  • Dura...

TREATMENT

MEDICATION

  • Oral analgesia: nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, tramadol; in severe cases, short-term pain relief with narcotics. Prednisone: short course of 40 mg da...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Presence of a fever and a tense joint capsule (i.e., a potentially septic joint, orthopedic surgical emergency)

  • Severe disease that is refractory to physical thera...

REFERENCES

1
Corpus KT, Camp CL, Dines DM, et al. Evaluation and treatment of internal impingement of the shoulder in overhead athletes. World J Orthop.  2016;7(12):776–784.
2
Parker B, Zlatkin M, N...

ADDITIONAL READING

Monica J, Vredenburgh Z, Korsh J, et al. Acute shoulder injuries in adults. Am Fam Physician.  2016;94(2):119–127. 

CLINICAL PEARLS

  • If caught early with no other shoulder pathology and treated with aggressive conservative therapy, many athletes are able to return to their prior level of competition.

  • With subacromial...

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