Shoulder Impingment

What is an impingement of the shoulder?

Impingement syndrome is when the tendons of the muscles in the shoulder become irritated and swollen as they pass through a narrow passage called the subacromial space. Physiotherapy is an excellent way of treating shoulder impingement.

What causes shoulder impingement?

Impingement can be caused by overuse of the shoulder, especially repetitive overhead activities and lifting in the gymnasium or at work. Shoulder impingement can also be caused by muscle imbalance of the shoulder.


What are the symptoms of shoulder impingement?

The first symptoms of impingement are mild. Therefore, many individuals do not seek treatment straight away. Symptoms gradually worsen over time. Initial symptoms include:

  • reduced range of movement

  • swelling/ inflammation

  • stiffness

  • weakness

  • joint clicking

  • joint locking

In advanced cases, impingement may progress to a "frozen shoulder."

What should I do if I have shoulder impingement?

If you suspect that you have an impingement then you should seek treatment as soon as possible. If left untreated shoulder impingement can become more and more painful and debilitating. 

Treatment for a shoulder impingement.

Physiotherapy is the preferred treatment choice for impingement of the shoulder. Surgery is not often performed unless a course of physiotherapy has been completed. You physiotherapist may suggest relative rest and tell you to avoid overhead activities. Physiotherapy will focus on reducing your pain, stretching any shortened muscle groups and strengthening weak muscle groups to allow you to return to normal activities as soon as possible. Physiotherapy treatments may include:

Your physiotherapist may also advise that you have a local anaesthetic and a cortisone injection in your shoulder to reduce the inflammation.

In the cases in which physiotherapy does not resolve the problem you may be referred for a surgical opinion. The surgeon can widen the subacromial space by removing a piece of bone creating more space for the rotator cuff tendons. This is called a subacromial decompression. Following surgery you will require physiotherapy to allow you to make a full and speedy recovery.

What shouldn’t I do if I have shoulder impingement?

If you suspect that you have a shoulder impingement than you should not ignore the problem. Without treatment and advice it may get worse.