Shoulder Impingement Syndrome

Shoulder impingement syndrome is one of the most common causes of shoulder pain, and becomes more common as we get older.  As the name suggests, the source of pain is from a pinching of the soft tissues in the shoulder between the bones of the shoulder.  Before we get too far into this we should talk about the anatomy of the shoulder.

The shoulder itself is composed of 2 bones: the humerus (the arm bone), and the scapula (shoulder blade).  The shoulder is unique because there is a portion around the joint itself where 2 bones are positioned very close to one another.  We call this area the subacromial space.  In this space, there are several soft tissue structures including the rotator cuff and a sack of fluid called the bursa.  This unique design is what contributes to the development of impingement syndrome, where those soft tissues get irritated or pinched, thus causing pain.

Symptoms of impingement syndrome:

  • Pain reaching behind back or into back pocket

  • Pain with overhead activity

  • Weakness or pain with lifting objects

  • Difficulty/pain with hair care

  • Pain/difficulty with putting on a jacket or coat

These symptoms generally progress over time and can progress relatively slowly in some individuals.  Many would chalk up their symptoms to “old age.”  As these symptoms continue, the dysfunction in the shoulder worsens and activities become more limited.  Many may find it difficult to lay on the affected side.

Risk factors:

  • Regular overhead activity like swimming or tennis

  • Repetitive motions like painting, cashiering, working at a desk

  • Occupations involving heavy lifting

  • Older age

  • Previous shoulder injuries

What causes shoulder impingement?

The causes of shoulder impingement can be as varied as the excuses a 5 year old makes about how the jar in the kitchen broke.  Some of the most common causes include, but are certainly not limited to: shoulder joint tightness, rotator cuff weakness, trauma, and falls, while sometimes there is no apparent cause.  Most of our patients don’t remember a specific incident of when the shoulder pain started, but they have all the signs of impingement.

What if I don’t get it treated?

Often the pain is intermittent in the beginning and we may think it’ll go away with time.  The pain may subside a bit, but the dysfunction continues.  With continued dysfunction the tissues inside the shoulder get weak, inflamed, and cause increasingly more pain, but in more serious situations it can lead to rotator cuff tears and potential surgical intervention.

How can I treat it?

As physical therapists we always recommend people get treatment for their bodily aches and pains that just don’t seem to go away.  As a result, we also believe that physical therapy is a great choice in treating shoulder impingement syndrome.  If you decide you want to try to treat it yourself, and are physically able, you can try these options:

  • Rest, avoid overhead motions/irritating motions

  • Drugs like ibuprofen to reduce pain and swelling

  • Ice the area following activity

  • Gentle stretching of the shoulder

If these don’t resolve the problem, it may be wise to consult your healthcare provider regarding options.

We know that the home treatment list is limited, and the reason for this is because there are many different causes of shoulder impingement, but they can all present with the same symptoms.  This is why it is advised to talk with a medical provider regarding your symptoms and history to determine the best course of action for you.

Thanks for reading!  You’re now smarter than you were yesterday!

CRAIG STEPHENS