Shoulder Impingement

The problem

• Is caused by pinching and compression of the rotator cuff tendons and the bursa (fluid-filled sac) between the upper arm bone and the shoulder blade
  
  
• If the shoulder blade is not held in a good position (from bad posture) or the rotator cuff muscles are weak, movements of the shoulder can lead to mechanical pinching and inflammation of the soft-tissues
• Pain may be located at the upper, front part of the shoulder, although it may extend to the back of the shoulder or even as far as the elbow
• Weakness and/or the inability to lift the arm above the head may also be a problem
  
  

Interesting facts

• Other names for shoulder impingement include swimmers shoulder, painful arc syndrome, throwers shoulder or supraspinatus syndrome
• In some individuals a congenital ‘hooked acromion’ may predispose them to shoulder impingement (see figure above right)

What you can expect/look out for

• Pain with above-head movements
• Pain is often worse at night
  
  

Hints for self-management

• Rest from aggravating activities, avoid overhead movement
• Try not to sleep on the side of your painful shoulder
  
  

Management options

• Conservative management includes rest and physiotherapy based exercises
• There is evidence to support the use of corticosteroid injection into the subacromial space
• Severe impingement that does not respond to conservative management may require acromioplasty and surgical decompression +/- a rotator cuff repair

More information

• The scapular stabilising muscles, namely the serratus anterior and the lower and middle trapezius, can often be weak which predisposes the shoulder joint to impingement
• Exercises are often targeted to affect the muscles that control the position of the shoulder blade as well as rotator cuff strengthening

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today - 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.