Shoulder Impingement

Shoulder Impingement

Shoulder Impingement

Shoulder impingement is a condition where the shoulder’s tendons or bursa get trapped and compressed. This compression can cause pain and sometimes even lead to other conditions like shoulder bursitis or rotator cuff tendinopathy. Often, this problem arises due to abnormal shoulder movements, which might be because of weak or in-coordinated muscles.

Where Does the Shoulder Impinge?

The main area where impingement occurs is the shoulder impingement zone. This is the narrow space between the head of the humerus (your upper arm bone) and the top of the shoulder blade. A simple click in the shoulder might be the first sign of this condition. If left untreated, this can escalate to more severe problems like reduced movement and loss of shoulder function. When talking about specific tendons, terms like supraspinatus or infraspinatus impingement come into play. The supraspinatus tendon is most commonly affected.

If you’re experiencing persistent pain, reduced movement, or weakness in your shoulder, it’s important to seek medical advice. Treatments can range from physiotherapy to surgery in serious cases.

Symptoms of Shoulder Impingement

Physiotherapist treating middle-aged patient for shoulder impingement
Effective Physiotherapy For Shoulder Impingement Relief

There are various symptoms linked to this condition:

  • Pain or a clicking sound when putting your hand behind your back or head.
  • Pain when reaching for something like a seatbelt.
  • An arc of pain when lifting your arm.
  • Discomfort when lying on the affected shoulder.
  • Persistent pain, even when resting.
  • Muscle pain or weakness during lifting or reaching.

It’s essential to get these symptoms checked out. If left untreated, they can worsen over time.

Tests for Shoulder Impingement

A qualified shoulder physiotherapist or doctor can perform tests to diagnose this condition. The aim is to pinpoint the exact problem and rule out other potential causes of shoulder pain. Tests can include checking the shoulder’s range of motion, assessing rotator cuff strength, and more. This comprehensive evaluation will aid in determining the best treatment plan.

Diagnostic Tests

An ultrasound scan can be a cost-effective way to diagnose this condition. It offers a dynamic view of the impingement and can detect other related injuries. On the other hand, an MRI might detect tears but won’t show dynamic impingement. X-rays aren’t very useful for detecting impingement either but can show if there are any bone abnormalities.

Always consult with a healthcare professional to decide the best tests for your situation.

Who is at Risk?

Individuals often engaged in overhead arm movements, like tennis players or swimmers, are more at risk. See Swimmers Shoulder.

Also, jobs requiring repetitive overhead lifting can increase the chances of developing this condition.

What Causes Rotator Cuff Impingement?

Rotator cuff impingement is a common shoulder problem with two main types of causes: primary (structural) and secondary (related to posture and movement).

Primary Rotator Cuff Impingement – Structural Narrowing

A key structural cause is the natural shape of your shoulder. Some people are born with a smaller space under the acromion (the top of the shoulder blade). This smaller space is known as the sub-acromial space. Additionally, conditions like osteoarthritis can lead to the development of bony spurs in this area, further reducing the available space.

When this space is narrowed, it increases the likelihood of compressing (or impinging) the soft tissues within, such as the bursa and rotator cuff tendons. This compression can lead to inflammation and irritation, resulting in conditions like bursitis or rotator cuff tendonitis.

Secondary Rotator Cuff Impingement – Dynamic Instability

The second type of impingement is related to how your shoulder moves – what we call dynamic instability. This means your shoulder joint moves excessively or has ligament laxity and muscular weakness around it.

This form of impingement often develops over time due to repetitive overhead activities, trauma, previous injuries, poor posture, or lack of use. When your shoulder is unstable, the rotator cuff is under more strain and has to work harder, which can lead to injury.

An overworked rotator cuff can become fatigued, inflamed, and weakened. This weakening can be due to pain inhibition or even tendon tears. As the rotator cuff becomes less effective, it can’t prevent the head of the humerus (upper arm bone) from moving upwards into the sub-acromial space. This upward movement can squash the bursa or rotator cuff tendons, leading to impingement.

The Importance of Proper Treatment

Without appropriate treatment, shoulder instability can lead to recurring injuries. Moreover, poor training techniques or overtraining can exacerbate the problem, leading to overuse injuries like bursitis or tendinopathy.

Treatment for Shoulder Impingement

The first step in treating this condition is identifying the root cause. Treatment can vary depending on the affected structure. It’s crucial to consult with a healthcare professional experienced in treating shoulder issues.

There are several stages to successfully rehabilitate shoulder impingement. These stages range from protecting the injured area to engaging in high-speed or high-load exercises before returning to sport or work. However, each case is unique, so a customised exercise program is vital.

If you suspect you have shoulder impingement, arrange a consultation with a shoulder physiotherapist or doctor for specific advice.


In conclusion, shoulder impingement is a prevalent condition that affects many, especially those involved in activities requiring repetitive overhead movements. It arises from the compression of the rotator cuff tendons and bursa in the shoulder, leading to pain and restricted movement. With early detection and the right treatment, it’s possible to alleviate the symptoms and prevent further complications.

Whether it’s through physiotherapy, medication, or in some cases, surgery, the key is to address the root cause and adopt a holistic approach to rehabilitation. If you’re experiencing symptoms of this syndrome, don’t hesitate to seek medical advice. Remember, early intervention can mean a quicker road to recovery and a return to pain-free movement.

Related Articles

  • Shoulder Bursitis Treatment, Physio & Helpful Tips: This article discusses the treatment and management of shoulder bursitis, a common source of shoulder pain due to inflammation of the shoulder’s bursa​​.
  • Rotator Cuff Tendinopathy – Physio Advice: Explores various aspects of rotator cuff tendinopathy, including its relation to shoulder blade pain and the effectiveness of cortisone injections for a torn rotator cuff​​.
  • What Is Your Scapulohumeral Rhythm?: Discusses the importance of neck-scrapulo-thoracic-shoulder function in treating shoulder pain and injury, providing a more holistic view of shoulder health​​.
  • Rotator Cuff Tear: A detailed look into rotator cuff tears, a condition that can be a consequence of or a contributing factor to shoulder impingement.
  • Swimmer’s Shoulder: This article is particularly relevant as it discusses an overuse injury common in swimmers, leading to shoulder pain and impingement symptoms.
  • Bicep Tendinopathy: Offers information on bicep tendinopathy, a condition affecting the bicep tendon leading to pain in the front of the shoulder, which can be related to or exacerbated by shoulder impingement issues.
  • Frozen Shoulder (Adhesive Capsulitis): Here, readers will find information on shoulder conditions related to muscle strain and stiffness, and surgeries like rotator cuff repair, which are relevant to shoulder impingement.
  • AC Joint Injury: This article discusses injuries to the acromioclavicular joint, common in athletes and after falls, offering insights into shoulder joint issues.
  • Shoulder Arthritis: It provides information on degenerative joint disease affecting the shoulder, causing pain and stiffness, which can be a concern for those with shoulder impingement.
  • Functional Shoulder Instability: This article discusses chronic shoulder instability, which can lead to recurrent subluxations and dislocations, a concern in shoulder impingement cases.

Shoulder Pain Causes

Common Injuries & Conditions

Understanding the common shoulder pain causes is crucial, as this discomfort can stem from various issues like rotator cuff injuries, arthritis, and frozen shoulder. Our guide offers a comprehensive exploration of these causes, providing insights into both acute and chronic conditions. It aims to equip you with knowledge and strategies for effective treatment and recovery, catering to those grappling with recent injuries or long-term pain. This resource is your go-to for navigating the complexities of shoulder pain and its management.

Shoulder Pain Causes
Shoulder Pain Causes

Rotator Cuff

Shoulder Impingement Syndrome

  • Shoulder Impingement: A condition where shoulder tendons are pinched during arm movements, causing pain and limited mobility.
  • Shoulder Bursitis: Inflammation of the bursa, a small fluid-filled sac in the shoulder, causing pain and discomfort.
  • Swimmer’s Shoulder: An overuse injury common in swimmers, causing shoulder pain and impingement symptoms.

Shoulder Stiffness

Shoulder Instability

Acromioclavicular Joint

  • AC Joint Injury: Involves damage to the acromioclavicular joint, common in athletes and after falls.

Bone Conditions

Post-Operative Physiotherapy

Post-Operative Shoulder Rehabilitation: Essential for recovery, involving tailored exercises and therapies to regain strength and mobility after shoulder surgery.

  • Subacromial Decompression: A surgical procedure to alleviate shoulder impingement symptoms.
  • Shoulder Arthroscopy: Minimally invasive surgery for various shoulder conditions.
  • Acromioplasty: Surgery to reshape the acromion and relieve impingement.
  • Rotator Cuff Repair: Surgical repair of a torn rotator cuff.
  • SLAP Repair: Surgery to fix a specific type of labrum tear in the shoulder.
  • Biceps Tenodesis: Surgical procedure to reattach the biceps tendon.
  • Biceps Tenotomy: Involves cutting the biceps tendon to relieve pain.
  • Total Shoulder Replacement: Replacement of the shoulder joint with artificial components.

Muscle Conditions

Neck Arm Syndromes

Referred Pain: Pain in the shoulder that originates from another area of the body, such as the neck or spine.

  • Neck Arm Pain: Pain that originates in the neck and travels down to the arm and shoulder.
  • Cervical Radiculopathy: Occurs when a nerve in the neck is compressed or irritated, leading to shoulder pain.
  • Thoracic Outlet Syndrome: A condition where nerves or blood vessels between the collarbone and first rib are compressed, causing pain in the shoulder area.

Systemic Conditions

  • Fibromyalgia: A chronic condition characterised by widespread musculoskeletal pain, including in the shoulder.
  • Rheumatoid Arthritis: An autoimmune disorder that can cause joint pain and damage throughout the body, including the shoulders.

Shoulder Products & FAQs

Explore our range of shoulder products and find answers to frequently asked questions about shoulder pain and treatment options.

Shoulder Pain FAQs

Your Comprehensive Guide to Understanding and Managing Shoulder Injuries

Welcome to the "Shoulder Pain FAQs" page, your go-to resource for understanding various aspects of shoulder pain, injuries, and how to manage them effectively. The shoulder is a complex joint that allows for a wide range of movements, but it is also susceptible to various injuries and conditions that can cause discomfort and limitations in daily activities.

In this comprehensive guide, we will explore the most common shoulder injuries, their causes, and how to identify and treat them. We'll also address frequently asked questions about specific shoulder conditions, providing you with valuable insights into your shoulder health.

shoulder pain guide
Shoulder Pain Guide

When Should You Worry About Shoulder Pain?

Shoulder pain can be caused by numerous factors, ranging from minor strains to more severe injuries. Knowing when to seek medical attention is crucial to prevent further damage and facilitate timely recovery.

Common Shoulder Injuries

We'll swing into the most prevalent shoulder injuries, shedding light on their causes, symptoms, and appropriate treatment options.

More info: Common Shoulder Injuries

What Causes Shoulder Pain?

Understanding the root causes of shoulder pain is fundamental to addressing the issue effectively. We'll explore the various factors that can lead to shoulder discomfort and how to mitigate them.

More info: What Causes Shoulder Pain?

What is Your Scapulohumeral Rhythm?

The scapulohumeral rhythm plays a vital role in shoulder function and movement. We'll explain what it is and its significance in maintaining a healthy shoulder.

More info: What is Your Scapulohumeral Rhythm?

Rotator Cuff: An In-Depth Analysis

The rotator cuff is a critical group of muscles and tendons in the shoulder. We'll dive into its anatomy, functions, and common problems associated with it.

More info: Rotator Cuff: An In-Depth Analysis

How Can You Tell If You Have Torn Your Rotator Cuff?

Identifying a torn rotator cuff can be challenging, but we'll provide you with essential signs to look out for and when to seek professional evaluation.

More info: How Can You Tell If You Have Torn Your Rotator Cuff?

Can You Diagnose A Torn Rotator Cuff Without An MRI?

Find out about diagnostic methods for a torn rotator cuff, including whether an MRI is always necessary for accurate diagnosis.

More info: Can You Diagnose A Torn Rotator Cuff Without An MRI?

Can You Lift Your Arm With A Rotator Cuff Tear?

Discover the limitations and challenges you may face if you have a torn rotator cuff and how to manage arm movement during the healing process.

More info: Can You Lift Your Arm With A Rotator Cuff Tear?

Will Your Shoulder Blade Hurt With A Torn Rotator Cuff?

Learn about the possible relationship between a torn rotator cuff and shoulder blade pain, and what it indicates about your shoulder health.

More info: Will Your Shoulder Blade Hurt With A Torn Rotator Cuff?

Will A Cortisone Injection Help A Torn Rotator Cuff?

Cortisone injections are sometimes used for shoulder pain, but their effectiveness in treating a torn rotator cuff is a point of interest we'll explore.

More info: Will A Cortisone Injection Help A Torn Rotator Cuff?

How Can You Make Your Rotator Cuff Heal Faster?

We'll provide practical tips and strategies to aid in the healing process of a torn rotator cuff and restore shoulder function more rapidly.

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Shoulder Bursitis: Understanding the Condition

What is shoulder bursitis, and how does it differ from other shoulder injuries? Get insights into this inflammatory condition and how to manage it.

More info: Shoulder Bursitis: Understanding the Condition

Shoulder Impingement: Causes and Solutions

Understand the concept of the shoulder impingement zone and the factors contributing to rotator cuff impingement and bursitis.

More info: Shoulder Impingement: Causes and Solutions

Frozen Shoulder: Overcoming the Stiffness

Discover how to unfreeze a frozen shoulder and regain a full range of motion through effective therapeutic approaches.

More info: Frozen Shoulder: Overcoming the Stiffness

Shoulder Dislocation/Instability: Seeking Stability

Explore the causes of shoulder dislocation and instability, and the fastest ways to promote healing and prevent future occurrences.

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Can You Fix Shoulder Instability?

Find out about treatment options to address shoulder instability and regain stability in the joint.

More info: Can You Fix Shoulder Instability?

AC Joint: Identifying and Managing Injuries

Learn how to recognise an injured AC joint and what steps to take for proper care and recovery.

More info: AC Joint: Identifying and Managing Injuries

Swimmers Shoulder: Causes and Remedies

If you're a swimmer or engage in repetitive overhead activities, understanding the causes of swimmer's shoulder and how to prevent it is essential.

More info: Swimmers Shoulder: Causes and Remedies

We hope this comprehensive guide will prove invaluable in your journey to understand and manage shoulder pain and injuries. However, it's essential to consult a healthcare professional for personalised advice and treatment based on your specific condition. Let's dive into the world of shoulder health together!

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