Shoulder Impingement Syndrome Causes, Prevention And Treatment


The rotator cuff rubs on your humerus and the upper outer border of your shoulder, causing shoulder impingement syndrome. Rubbing causes edema to increase and the area to become more congested, which causes discomfort and irritation. Rest, ice, anti-inflammatory drugs, physical therapy, cortisone injections, and surgery are among forms of treatment.

Shoulder impingement happens when your rotator cuff rubs up against (or 'impinges on') or is pinched below it by the upper outer edge of your shoulder blade, known as the acromion.

Your rotator cuff, which is represented in the figure, is a quartet of muscles that arises from your shoulder blade and joins to your arm bone as a 'cuff' of tendon (humerus).

To raise your arm overhead and to rotate it in both directions relative to your torso, use your rotator cuff. The rotator cuff is vulnerable to being "impeded" or squeezed between these bones because of this configuration, which can result in "impingement syndrome."

A set of muscles known as the rotator cuff is located in the confined region between the acromion and the humerus.

Similar to how your ankle expands when it is sprained, your rotator cuff does when it is inflamed or damaged. Yet because your rotator cuff is encircled by bone, swelling leads to other things. Swelling decreases the area around the rotator cuff, which causes friction with the acromion. The friction of the rotator cuff tendons causes swelling, which further reduces the area below the acromion, creating a vicious cycle. As the area where the rotator cuff rests becomes even more constrained due to bone spurs on the acromion bone, impingement may result.

Those who participate in sports and other activities that require a lot of overhead rotational motion, such as swimming, baseball, volleyball, and tennis, as well as tasks like window cleaning and painting, are more likely to get shoulder impingement syndrome.

A fall onto an extended arm or other type of damage can potentially cause shoulder impingement.

44% to 65% of complaints of shoulder discomfort are estimated to be caused by shoulder impingement syndrome.


Underneath the acromion, your rotator cuff tendon goes through. The acromion is the bony protrusion from the top of the rear side of this bone that forms the outside border of your shoulder blade (scapula).It joins the clavicle, the end of your collar bone, at your shoulder. As the tendon bumps up against the acromion, shoulder impingement happens.

This impingement has several causes, including:

Your tendon is inflamed or torn. This may be brought on by injury, overuse through repeated shoulder motion, aging-related wear and tear, or both.

Your bursa is swollen and irritating. The fluid-filled sac between your tendon and the acromion is known as your bursa. Your bursa facilitates the motion of your tendons and muscles across your bones. Your bursa might change owing to injury or overuse of the shoulder, inflamed.

You either have age-related bone spurs on your acromion or your acromion is not flat (you were born with this condition).

How to check if you have Shoulder Impingement Syndrome?

Consult a doctor if your shoulder pain does not go away after a few weeks or is keeping you from doing your normal activities.

Your arm will be asked to be moved in various directions as they examine your shoulder to see how readily you can move it and whether movement makes the discomfort worse.

They could advise you to attempt a few therapies or recommend you to a physiotherapist for treatment guidance. You will not likely need to visit the hospital for any scans.

Without first visiting a doctor, you can also go directly to a physiotherapist, although you might have to pay.

Risk Factors

Symptoms can be brought on by even a little amount of bursa or tendon swelling. Injury to the shoulder joint is another condition that raises the likelihood of developing shoulder impingement syndrome especially in sports that require repeated arm and shoulder motions, such as tennis, swimming, baseball, and football.


Indicators of shoulder impingement syndrome include the following:

  • The discomfort of having your arms raised above your head.
  • Pain while reaching, raising your arm, or lowering it from an elevated posture.
  • Your shoulder's front may hurt and feel sensitive.
  • Ache that travels down the side of your arm from the front of your shoulder.
  • Your ability to sleep is affected by nighttime pain or ache.
  • Pain while reaching behind your back, such as when opening a zipper or reaching into a back pocket.
  • Stiffness and weakness in the arms and/or shoulders.
  • Often, symptoms appear gradually over a few weeks to months.

Bursitis and rotator cuff tendonitis, two additional prevalent causes of discomfort in the shoulder, are closely associated to shoulder impingement. A minor tear or hole in your rotator cuff, known as a rotator cuff tear, can cause shoulder discomfort, which is an indication of a more serious damage. You will likely have substantial weakness and might not be able to raise your arm against gravity if your rotator cuff has totally ripped. Moreover, as a result of this ongoing impingement process, your biceps tendon may rupture (tear).


You may avoid developing shoulder impingement syndrome by:

Preserving adequate shoulder and shoulder-blade muscular strength. The right combination of shoulder-region muscle strength is essential for a healthy shoulder. Over time, there is a higher chance of impingement and injury if there is an imbalance in muscle strength.

Maintaining a healthy range of motion and mobility in the shoulders, neck, and middle back. The mobility of nearby joints helps the shoulder stay healthy and operate as it should.

When reaching and throwing, maintain good posture and use excellent shoulder mechanics. By doing so, the risk of shoulder impingement and excessive shoulder tension are diminished.

Avoiding broad shoulders and forward head positions (such as spending a lot of time hunched over, sitting at a computer). Bad posture practises strain the shoulder at places where an impingement is more likely to occur.


Reducing your discomfort and regaining shoulder function are the main objectives of therapy for shoulder impingement syndrome. Impingement syndrome can be treated with rest, ice, over-the-counter pain relievers, steroid injections, and physical therapy.

  • The most crucial kind of treatment for shoulder impingement syndrome is physical therapy. Most of the time, learning how to continue physical therapy on your own at home may be accomplished with just one or two office visits. You will learn stretches to increase your shoulder's range of motion. You may start doing strengthening exercises to strengthen your rotator cuff muscles when your discomfort subsides.
  • Once or twice a day, the shoulder should be exposed to ice for 20 minutes. (A bag of frozen peas or corn also works great).
  • If your medical professional Ibuprofen or naproxen may be given as required to treat pain if the doctor allows. A cortisone injection into the bursa below the acromion or a heavier prescription level anti-inflammatory drug may be prescribed for more acute discomfort.
  • It is beneficial to approach things with common sense. Avoid tasks that require you to reach overhead or behind your back. Usually, these movements exacerbate shoulders with impingement syndrome. Avoid doing these motions-requiring tasks until your discomfort subsides.


If nonsurgical therapy are unsuccessful in relieving your discomfort, surgery is recommended. One procedure known as an arthroscopic shoulder decompression or subacromial decompression involves removing a portion of the acromion to provide more room for the rotator cuff. Using small cuts (incisions) in the joint, arthroscopic surgery can be used to conduct this operation.

A partial rotator cuff rupture, biceps tendon irritation, and shoulder arthritis can all be treated at the same time as surgery for your shoulder. Another alternative is open surgery, which involves making a wider incision in the front of your shoulder.

Complications of Shoulder Impingement Syndrome

Impingement syndrome, if untreated, can result in bursitis and/or tendinitis of the tendons (bursitis). The rotator cuff tendons will start to weaken and rip if improper care is not taken of them.


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Page last reviewed: Apr 27, 2023

Next review due: Apr 27, 2025

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