What is Shoulder Impingement?
Impingement syndrome is an increasingly common
cause of shoulder pain. The rotator cuff is a sling of muscles which
support the glenohumeral joint. Over time, with movement, the tendons and bursae
within this complex become trapped and compressed, developing tears or inflammation
causing an acute flare up in pain.
can cause it?
Within the shoulder girdle, the muscles of the
rotator cuff should glide smoothly beneath acromion. With overhead arm
movement, this subacromial space narrows and when this happens repetitively,
the friction between the structures can become inflamed causing pain.
of shoulder impingement:
impingement – this is caused by structural changes within the joints such as
bony spurs which can narrow the subacromial space.
impingement – this is affected by a person’s posture and movement patterns such
as increased joint mobility or muscle imbalance within the girdle.
People with who participate in physical activity or
have occupations which involve repetitive overhead movement are most at
If you have any of these symptoms, it can have huge
impacts on your quality of life and occupational ability.
when bringing your arm into an arc above head, cross body or hand behind back
when lying on the affected side.
and loss of function of the affected shoulder.
examination using specific shoulder tests.
is often used to assess the extent of the impingement along with associated
tendinopathies, bursitis or muscle tear.
are sometimes used to rule out and bony deformities such as arthritis or
- 1. Corticosteroid
Injection – Not a long term solution. The relief provided is transient, it is
helped in cases where the pain is very severe.
- 2. Subacromial
Decompression Surgery – There is high quality research which reveals that there
is no differences in outcomes.
- 3. Physiotherapy
– a 12- week program of graded exercises has proven to reduce pain and to
improve strength and function.
When treating shoulder impingement, it's important
to determine which type of impingement you are having and to consider the cause
of the impingement as opposed to the specific structures involved. Our posture,
muscle strength and muscle length in our upper trunk play an important role.
Through strengthening, stretching and postural re-education with the guidance
of your physiotherapist, we aim to regain your full range of motion, restore
the shoulder strength and scapular stability and return you to a healthy and
pain free movement pattern.
Written By: Mary Wrixon, Physiotherapist