AOPT Health Blog
Shoulder Impingement Syndrome

Shoulder pain is one of the most common physical ailments people complain of. The shoulder joint is very complex and is made up of many different structures. This allows the joint to have a wide range of motions but, also makes it susceptible to many different injuries – one of the most common being impingement syndrome.


The shoulder joint is made up of three bones: the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collar bone). Your rotator cuff is a group of muscles that attach from the scapula to the humerus and its main function is to stabilize the shoulder and keep the humerus in the joint socket, it also helps with the movement of the shoulder. Impingement is caused when the humerus pinches structures between the top of the humerus and the bones at the top of the joint socket while you raise your arm. The most common cause is inflammation of the rotator cuff muscles within the joint space.

This injury is most often seen in young or middle-aged adults who are physically active in overhead sports or whose job is physically demanding and/or repetitive such as construction or painting. However, sometimes this can result from a trauma to the shoulder or for no apparent reason at all. The most common causes of impingement include:

  • Repetitive overhead movements such as golfing, tennis, throwing, swimming, overhead reaching, and weightlifting.
  • Injury – usually a fall where the shoulder gets compressed
  • Bony abnormalities of the acromion (bony prominence of the scapula at the top of the shoulder) which results in narrowing of the subacromial space (space between the top of the humerus and acromion.
  • Shoulder osteoarthritis
  • Poor strength in the rotator cuff muscles resulting in abnormal movement of the humerus within the joint space
  • Thickening of structures within the joint space such as the bursa, tendons, or joint capsule.

Signs and Symptoms

The following signs and symptoms are common in shoulder impingement and rotator cuff injuries

  • Limited ability to reach overhead along with muscle weakness with movements such as reaching out to the front, to the side, or behind your body.
  • Pain with shoulder movements such as reaching overhead, to the side, or beside your body.
  • Pain with attempting to sleep on the affected shoulder.
  • Pain with throwing or other similar shoulder movements.


This condition can be preventable. The following are tips to work on incorporating into your daily life in order to avoid shoulder injuries:

  • Maintain proper strength in the shoulders and shoulder blades. This may need to be a greater level of strength for those who participate in overhead activities or have physically demanding jobs compared to those who have a more sedentary lifestyle.
  • Regularly stretch the shoulders, neck, middle back regions.
  • Maintain proper posture while reaching or throwing.
  • Avoid a forward head and rounded shoulders (hunched) position while sitting at a desk or table for extended periods of time.

How Can Physical Therapy Help?

Physical therapists can help by diagnosing your injury, then formulating a tailored treatment plan to help you recover as soon as possible. During your first appointment, the physical therapist will listen to your history, assess your body mechanics, strength, range of motion, and test the integrity of your internal ligaments. Once a diagnosis has been formed, the physical therapist will devise a treatment plan that may include a combination of manual therapy, pain education, stretching, and strengthening. Towards the end of treatment physical therapy sessions will focus more on strengthening and functional training to help you return to your previous level of activity pain-free. If you experience discomfort in your shoulder or simply want to discuss how physical therapy can help, sign up for a free screen with one of our physical therapists.


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