Shoulder Pain

Shoulder Impingement Syndrome

What is shoulder impingement syndrome?

  • It is basically a squashing or impingement of the structures underneath the part of the scapula called the acromion. These include the subacromial bursa and rotator cuff muscle tendons.
  • It happens as a result of injury, overuse or alterted movement and mechanics affecting the shoulder blade.


The bursa or cuff muscle impinges leading to bursitis or rotator cuff impingement and tears

What causes Subacromial impingement?

  • Repeated strains placed on the shoulder especially with over head activities coupled with poor postures.
  • An abnormally shaped acromion may also lead to this problem.
  • Other reasons include poor scapular stability or shoulder instability. It may need an expert to identify the root cause for your impingement if it fails to settle down in 4 to 6 weeks time.

What are the signs & symptoms?

  • Pain at the shoulder.
  • Difficulty raising your arm due to pain.
  • Painful overhead and reaching movements.

How do I manage this problem?

  • Keeping an erect shoulder posture helps take the pressure off of the structures under the acromion.
  • Ice packs (15 to 20 mins, 3 to 4 times a day)
  • Caution with over head movements.
  • Anti-inflammatories (NSAIDS) in the acute painful stages (first 2 to 3 weeks). These should not be continued for more than that period if the pain fails to settle down.
  • Gentle shoulder movements within your pain limits helps to maintain joint mobility and avoid stiffness.
  • Exercises: Please refer to our PDF documents and video links for more advice and self management on this problem.

What other treatments are available?

  • Physiotherapy may help your symptoms. However any treatment must be followed with a specific exercise program to acheive full recovery.
  • Steroid injection could be helpful if physiotherapy, anti-inflammatory medication and self-management exercises have not helped.
  • If all these fail you may need further investigations, which may include ultrasound scans most commonly, to see if you would benefit from surgery.