Orthopedic Specialist Dr. Gregory Gasbarro Discusses Shoulder Impingement

Gregory V. Gasbarro, M.D., is a Board Certified, Shoulder Fellowship-trained orthopedic surgeon at The Shoulder, Elbow, Wrist and Hand Center at Mercy in Baltimore, MD. Dr. Gasbarro specializes in the repair and reconstruction of injuries to the shoulder. He also sees patients with conditions and injuries of the elbow, wrist and hand. In a recent interview, Dr. Gasbarro explored the topic of shoulder impingement:

What is shoulder impingement?

It is the first stage of rotator cuff disease which ranges from subacromial bursitis or rotator cuff tendonitis to rotator cuff tears and ultimately rotator cuff tear arthropathy. Impingement is the most common cause of shoulder pain.


Causes of shoulder impingement?

This is still debated. Early belief was that extrinsic pressure on the rotator cuff between the greater tuberosity (where the rotator cuff attaches) and the undersurface of the acromion which is part of the scapula led to attritional degeneration of the tendon causing subacromial bursitis and ultimately tearing. More recent studies have focused on anatomic factors such as the angle between the socket and the end of the acromion to determine if this a contributing factor to which patients develop symptoms.


How to diagnose shoulder impingement?

Primarily on history and physical exam. Patients come to the office with pain over the lateral shoulder at the location of the deltoid. The pain often radiates down the arm and is worse with overhead and reaching activities. Night pain is also a common complaint.


Which exercises are best?

Rotator cuff strength and scapular stabilization.


How to prevent future injuries?

Avoid activities that hurt, particularly overhead and reaching activities out away from the body with the elbow extended.


What kind of physical therapist can help?

Certified therapists specifically trained to work with shoulder patients.


Extra tips to share?

Surgery to fix a torn rotator cuff in this scenario is necessary only after a patient has failed a minimum 6 weeks of formal physical therapy +/- a cortisone injection.


Dr. Gasbarro provides comprehensive care for conditions and injuries affecting the upper extremities. He offers a particular focus on conditions of the shoulder, providing advanced, data-driven care for degenerative disease, acute trauma and work and sports related injuries. He offers diagnosis and treatment for such conditions as shoulder arthritis, rotator cuff injuries, bicep tendon injuries, labral tears, shoulder and clavicle fractures and AC joint injuries.