Shoulder Impingement

Shoulder impingement occurs when the shoulder rotator cuff and/or bursa and tendons become trapped and compressed within the shoulder. The impingement usually occurs when the arm is lifted about halfway to the overhead position. A shoulder impingement can affect the ability to lift the arm or use it for any force production, such as throwing a ball. Often a shoulder impingement begins as pain during arm movements and can lead to significant functional weakness over time.

What Causes a Shoulder Impingement?

There are many causes of a shoulder impingement. One cause can be narrowing of the space inside the shoulder where the ball joint sits. This can cause damage and irritation to the rotator cuff tendons. This narrowing may be due to changes in the bony structures of the joint or changes within the soft tissues. This leads to a loss of function in the surrounding muscles.

Another cause of a shoulder impingement is poor posture or muscle weakness. Prolonged slumped positions or round-shoulder posture can cause reduced function of the shoulder muscles, increasing the risk of a shoulder impingement.

What are the Symptoms of a Shoulder Impingement?

The most common symptoms of a shoulder impingement include:
  • Pain or clicking when the hand is moved behind the head or back
  • Pain when lifting the arms to shoulder height or above
  • Pain when lying on the affected shoulder
  • Muscle weakness
  • Pain at rest during later stages

What is the Best Treatment for Shoulder Impingement?

Due to the many reasons for shoulder impingement and the various structures involved there are several different treatment methods. The most important step initially is to find out why the shoulder impingement is occurring. This will determine the most effective approach for each patient.

Shoulder Physiotherapy treatment can be effective in relieving pain and restoring function. Impingement is often made worse by joint stiffness, muscle tightness and poor muscle activation. Massage or dry needling can be effective in reducing the additional tension local muscles are creating during shoulder impingement. Deep tissue massage and trigger point techniques can also help to release tension from muscles that may be affecting shoulder function. These techniques can be a part of shoulder physio treatment.

Does Physio Help a Shoulder Impingement?

One of the most effective treatments for a shoulder impingement is shoulder physio. Rehabilitation can include strengthening and stretching exercises which help to restore shoulder stability and normal motion. As mentioned above, massage can be incorporated into the treatment plan to improve movement and function, as well as mobility exercises. If the goal is to return to sport, a physiotherapist will guide the patient carefully to return to their chosen sport in stages as their condition allows. Shoulder physio also provides prevention techniques to reduce the risk of another shoulder injury. 

The majority of patients with shoulder impingement recover with shoulder physio and can return to normal activities within 4-6 weeks. For severe cases, it can take several months, particularly for those who have had the condition for a long time. Early physio treatment is important to accelerate recovery; however, shoulder physio is effective for both acute and chronic shoulder injuries.