Shoulder Impingement Syndrome

What Is Shoulder Impingement Syndrome?

Shoulder impingement syndrome occurs when the tendons of the rotator cuff muscle (the group of muscles and tendons that stabilize the shoulder) become pinched or irritated as they pass through a narrow space beneath the acromion (the top part of the shoulder blade). This can result in pain, inflammation, and reduced shoulder movement.

Impingement is often associated with repetitive overhead movements or poor shoulder mechanics, leading to inflammation and gradual damage to the tendons and surrounding structures.

What Causes Shoulder Impingement?

The most common causes of shoulder impingement include:

Overhead movements: Frequent overhead activities such as lifting, throwing, or swimming
Rotator cuff tendinitis: Inflammation of the rotator cuff tendons
Shoulder instability or weakness: Lack of shoulder muscle strength or improper biomechanics
Age-related changes: Degeneration of the rotator cuff or the bony structures in the shoulder, particularly in individuals over 40
Previous injury or trauma: A fall or direct blow to the shoulder can lead to impingement

Symptoms of Shoulder Impingement Syndrome

Common symptoms include:
Pain in the shoulder (especially when lifting the arm overhead or behind the back)
Pain on the outer side of the shoulder that may radiate down the arm
Weakness in the shoulder, particularly during lifting or overhead movements
Pain during sleep, especially when lying on the affected side
Limited range of motion and a feeling of the shoulder “catching” or “grinding”
Stiffness in the shoulder joint

Symptoms of Shoulder Impingement Syndrome

Accurate diagnosis is essential for effective treatment. At our clinic, we use the following methods:

Detailed clinical examination: We assess shoulder movement, strength, and posture to identify signs of impingement
Diagnostic musculoskeletal ultrasound: This allows us to visualize the soft tissues (tendons, bursae) in real-time, enabling precise diagnosis of any inflammation or damage
X-rays or MRI: These may be recommended to rule out other structural issues, such as tears or arthritis, that may be contributing to impingement

Treatment Options for Shoulder Impingement

Our clinic offers a variety of evidence-based treatments to relieve symptoms, promote healing, and improve shoulder function:

Physiotherapy

Physiotherapy is one of the most effective treatments for shoulder impingement. Our tailored physiotherapy approach focuses on:

Stretching exercises to improve flexibility in the shoulder and surrounding muscles
Strengthening exercises for the rotator cuff muscles to improve stability and reduce strain on the tendons
Postural correction to ensure proper alignment and movement mechanics, especially during overhead activities
Manual therapy and joint mobilisations to reduce stiffness and pain
Activity modification and education to avoid exacerbating movements

Ultrasound-Guided Injections

In cases where conservative physiotherapy alone does not provide sufficient relief, we offer ultrasound-guided corticosteroid injections to reduce inflammation and relieve pain directly at the site of impingement. This treatment provides:

Shockwave Therapy (if available)

Shockwave therapy can help promote healing in the tendons and reduce inflammation. It involves applying high-energy sound waves to the shoulder to stimulate tissue repair and pain relief.

Surgical Referral (if necessary)

In rare cases, if impingement is severe or unresponsive to non-surgical treatment, we may refer you to an orthopaedic surgeon for further evaluation. Surgery options, such as subacromial decompression, may be considered to relieve pressure on the tendons and improve shoulder function.