Everything You Need to Know About Shoulder Impingement
What is Shoulder Impingement?
Shoulder impingement is a condition where the rotator cuff tendons or bursa get pinched or compressed between the top of the arm bone (humerus) and the acromion (part of the shoulder blade). This pinching causes pain, inflammation, and difficulty lifting or rotating the arm, especially during overhead movements. It’s one of the most common causes of shoulder pain.
An analogy…
Imagine the space between your arm bone and shoulder blade like a narrow tunnel. If the roof of the tunnel drops or the tissues inside swell, it causes a traffic jam, things rub and get irritated. That’s what happens with impingement: the tendons get squashed, and it hurts to move.
What causes shoulder impingement?
The shoulder joint is surrounded by a space known as the subacromial space, where the rotator cuff tendons pass through. If this space becomes narrowed, due to poor posture, weak muscles, tight structures, or bony changes, the tendons and bursa can get compressed. This leads to irritation and inflammation, especially during overhead activities.
What are the signs and symptoms of shoulder impingement?
- Pain in the front or side of the shoulder, especially with reaching or lifting overhead
- Pain that worsens with activity and eases with rest
- Discomfort when lying on the affected shoulder
- Weakness or difficulty with movements like brushing hair or reaching behind the back
- A feeling of catching, pinching, or clicking during movement
- Limited range of motion due to pain
What tests are used to diagnose shoulder impingement?
Neer’s Test: The practitioner lifts the patient’s straight arm up in front of their body while stabilising the shoulder blade. If this movement causes sharp pain in the front or top of the shoulder, it suggests the rotator cuff tendons or bursa are being pinched under the acromion.
Hawkins-Kennedy Test: The patient’s arm is raised to shoulder height and bent at the elbow. The practitioner then gently rotates the arm inward. If this causes pain in the front or side of the shoulder, the test is positive for impingement.
How long does shoulder impingement take to heal?
Recovery time depends on the severity and how early it’s treated. Mild cases may improve in 2–4 weeks with rest and rehab. Moderate to chronic cases may take 6–12 weeks, and more severe or longstanding impingement might take a few months. With consistent treatment, most people recover without surgery.
How does shoulder impingement happen?
- Repetitive overhead activity
- Poor posture
- Weak rotator cuff or scapular muscles
- Tight chest or upper back muscles
- Shoulder instability or previous injuries
- Bony spurs narrowing the subacromial space
What treatment can help shoulder impingement?
- Manual therapy to improve joint alignment and muscle function
- Postural correction and ergonomic advice
- Rotator cuff and scapular strengthening
- Dry needling, massage, or taping as supportive techniques
What exercises or stretches can I do for shoulder impingement?
- Scapular retraction and setting
- Resistance band external rotations
- Thoracic mobility drills and pec stretches
- Wall slides and overhead control exercises
- Postural strengthening
What products can help with shoulder impingement?
Resisted shoulder external rotations in neutral
Stand in an upright position. Hold a tensioned exercise band in both hands and bend your elbows to a right angle. Keep your shoulder blades back and down and rotate your symptomatic arm outwards, keeping your elbow loosely by your side and your shoulder blades in a good position. Control the movement then return back to the start position. Relax and repeat.
Resisted GHjt IR(N) in stand
Stand upright and tie a resistance band to a solid object beside you. Hold the other end in your affected hand with some tension in the band. Bend your affected elbow to a right angle. Keep your shoulder blades back and down, and rotate the arm inwards, keeping your elbow loosely by your side and your shoulder blades in a good position. Control the movement back to the start position.
Eccentric anterior deltoid short lever
Stand straight holding a broom-stick or rod in both hands. Lift your symptomatic arm up as far as you can using your good arm to drive the movement. Do not allow your shoulder to hunch. Remove the support of the stick and slowly lower your arm, keeping your elbow bent and your hand close to your face. Relax and repeat.
Scapular squeeze
Bend your elbows and rotate your forearms out. Bring your elbows to your sides as you squeeze your shoulder blades together for a few seconds, and relax
