Summary

When muscles, bones and tendons in your shoulder cause you pain as you move, it’s called shoulder impingement. Common treatments include rest, exercises, steroid injections and surgery. It’s recommended that patients with shoulder impingement avoid activities that exacerbate the pain and instead embrace rest, targeted exercises, and specific treatments, such as the physiotherapy offered at White House Clinic’s 14 locations. Studies have shown that up to 90% of patients show improvement after nine sessions of physiotherapy treatment.

An overview of shoulder impingement 

Your shoulder is a complex piece of anatomy. Eight muscles and four tendons support it. When a tendon inside the shoulder rubs or catches nearby tissue or bone as you raise your arm, causing pain, it is called shoulder impingement. 

Symptoms of a shoulder impingement include:

• Pain in the top and outside of the shoulder
• Pain when you lift your arm or put on a jacket
• A locking sensation during specific movements
• Pain and aching at night when lying on the affected side 
• Arm weakness

Causes of shoulder impingement

Shoulder impingement can happen due to wear and tear, overuse from sport, or injury.

The common causes of shoulder impingement are having swollen, thickened or torn tendons; inflamed and irritated fluid-filled sacs around the joint; curvature of the acromion, where the shoulder blade meets the collarbone; and bony growths on the acromion.

When to see someone for shoulder impingement

If you have shoulder pain that doesn’t go away in a few weeks and prevents you from doing your everyday activities, see your GP or a physiotherapist. The professional will assess the shoulder, explore how you move it, and note when you feel pain.

What to do if you have shoulder impingement

If you think you have a shoulder impingement, a GP or physiotherapist can provide targeted exercises.

Avoid activities that trigger pain and those that require repetitive arm movements above your head, such as swimming or tennis. Your physiotherapist or GP will let you know when to restart the activities.

Keep moving your arm and carry on with your normal daily activities to avoid stiffness. You may also use ice therapy two or three times a day and take over-the-counter painkillers such as ibuprofen or paracetamol.

If you play sports or are in a profession that involves repetitive movements, check your technique and seek advice from a professional on stretching and strengthening exercises.

Treatment for shoulder impingement

Treatment for shoulder impingement includes rest, exercises, steroid injections, and surgery.

Rest

If you have shoulder impingement, you should allow your body to try to heal itself by finding another way to do daily activities that cause pain. Wearing a sling is rarely required.

Exercises for shoulder impingement

An impinging shoulder can improve within weeks or months following prescribed exercises. First, a physiotherapist will assess your shoulder movement and pain levels to diagnose shoulder impingement. Then, they’ll prescribe exercises to build your strength and increase movement in the area. Following a bespoke exercise plan will support tissue healing and movement. You must listen to your body when performing prescribed exercises. The exercises may initially increase symptoms; however, they should become easier with regular practice.

Steroid injections for shoulder impingement

Patients may need steroid injections if rest and exercises do not help on their own. Steroid injections reduce redness and swelling in the nearby muscle or joint, helping ease pain and stiffness.

Surgery for shoulder impingement

Surgery to treat shoulder impingement is called subacromial decompression. This keyhole surgery widens the space around the tendon, preventing it from rubbing against the bone or tissue. You will have a general anaesthetic, and most people will go home the same day or the day after. Within a few weeks, you should be able to use your shoulder.

Who’s affected?

Shoulder impingement affects 20% of people at some point in their lifetime. It is most common between the ages of 45 and 65.

Reducing the risk of shoulder impingement happening again

To prevent shoulder impingement in the future, build up the muscles in the rotator cuff by following the exercises your physiotherapist prescribes. You should also keep good posture, as slouching limits the space in the rotator cuff.

At the White House Clinic, we offer physiotherapy consultations and treatments across South Yorkshire, North East Derbyshire and Nottinghamshire, helping you prevent, manage, or recover from your shoulder impingement.

References

• Oxford Shoulder & Elbow Clinic
• Shoulder impingement - NHS
• Shoulder Impingement Syndrome