What is shoulder impingement?
Shoulder impingement syndrome is a common cause of shoulder pain. It happens when the tendons and soft tissues in your shoulder get irritated or pinched, especially with frequent overhead movements like swimming, tennis, volleyball or even lifting objects.
Repetitive motions can cause these tissues to rub against nearby bones, leading to discomfort and inflammation. It can also happen after a minor injury, like falling on your shoulder or reaching out to catch yourself. Sometimes, the exact cause isn’t clear.
If shoulder impingement isn’t treated, the pain can get worse and make it hard to move your arm or do daily activities. Early treatment can help relieve discomfort, reduce inflammation and restore shoulder function.
Anatomy of the shoulder
The rotator cuff is a group of four muscles and tendons that connect your shoulder blade to your upper arm bone (humerus). These muscles help you lift, rotate and move your arm while also keeping your shoulder stable.
Shoulder impingement happens when the rotator cuff gets pinched between the top of your arm bone and the bony part of your shoulder blade (called the acromion). This pinching can cause pain, inflammation and limited movement, especially when you reach overhead or behind your back.
Types of shoulder impingement
There are a few components of shoulder impingement that can cause symptoms to develop. Your healthcare provider might say that you have a more specific issue, including:
Shoulder impingement symptoms
Shoulder pain is the most common symptom of shoulder impingement. It often feels like it’s coming from the front of your shoulder and can spread down the side of your arm. The discomfort may also:
- Make your shoulder feel tender to the touch
- Worsen at night, making it hard to fall or stay asleep
Certain movements or positions can make the pain worse, including:
- Reaching your arm overhead
- Lifting or lowering your arm
- Reaching behind your back (like grabbing a wallet or unzipping a purse)
- Lying on the affected shoulder
When to see a doctor
See your doctor whenever shoulder discomfort interferes with your day-to-day activities and doesn’t get better with over-the-counter medications. Many people with shoulder impingement don’t seek help in the early stages of the condition, but talking to a provider may allow you to treat your condition with less invasive treatments.
Shoulder impingement causes and risk factors
Shoulder impingement happens when the space at the top of your shoulder narrows, putting pressure on the tendons and soft tissues. Repeated movements, like raising your arm overhead, can cause irritation, small tears and swelling, making it harder for your shoulder to move smoothly.
Athletes in sports like swimming and tennis, as well as people who do overhead activities like construction or painting, are more likely to develop this condition. Shoulder impingement can also occur after an injury, such as a fall or car accident. It can cause pain, weakness and difficulty moving your shoulder, especially when reaching or lifting your arm.
How is shoulder impingement diagnosed?
Most of the time, a doctor can diagnose shoulder impingement with a physical exam. During the exam, your doctor will ask about your symptoms, including when the discomfort started, if it has become worse over time, and if your job or hobbies require repetitive motion. They’ll also check for other shoulder and joint problems, including a rotator cuff injury, pinched nerve or arthritis. Sometimes, imaging tests are needed to rule out other possible causes of your discomfort.
Shoulder impingement treatment
There are several treatment options for shoulder impingement, but the most common include rest and avoiding the activities or arm positions causing your pain. Other treatments can include over-the-counter pain relievers and applying ice or heat to the area to reduce discomfort and swelling, and physical therapy to strengthen your shoulder and improve its range of motion. You may need surgery if conservative treatments aren’t effective.
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