Shoulder impingement happens when bone rubs against tissue in the your shoulder joint, causing pain. It's common in athletes and people who do repetitive, overhead movements for work.
Most cases dramatically improve with rest, shoulder impingement exercises, and medicine.
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Shoulder impingement is when the shoulder blade gets too close to tissue in the rotator cuff — the group of tendons and muscles surrounding the shoulder joint. When this happens, it causes irritation, swelling, and pain.
Shoulder impingement makes it difficult to throw, or move your arm above or behind you. Impingement syndrome requires rest, physical therapy, and in some cases, surgery. Without treatment, the problem will likely get worse over time.
Shoulder impingement is responsible for up to 65% of all doctors' visits for shoulder pain, according to the National Library of Medicine.
Shoulder impingement usually happens when the tendons or fluid-filled sacs (bursa) in the rotator cuff become swollen from overuse. Because there's little space in the shoulder, the swollen tissue hits against the shoulder bone. This leads to pain and further swelling.
In some cases, a bone spur grows on the shoulder bone which irritates tissue in the joint.
Shoulder impingement is more common in athletes and people who use their shoulder muscles at work.
People are more likely to get shoulder impingement if they:
If not addressed, shoulder impingement can cause bigger problems, including:
Follow these tips to avoid shoulder impingement:
Symptoms of shoulder impingement tend to come on slowly and get worse over time. The main symptom is pain, especially:
You also may have stiffness or weakness in your shoulder.
Seek treatment when you notice shoulder impingement symptoms, so you can prevent your shoulder problem from getting worse.
Your doctor will diagnose shoulder impingement based on your symptoms. They may also order an imaging test.
Your doctor will ask you questions about your lifestyle and pain, including:
Your doctor will have you move your arm and shoulder in various ways. They'll also gently move your arm to assess what types of movements cause pain.
Your doctor will order an imaging test if they're not sure of the diagnosis or if your symptoms aren't improving with therapy. Imaging options include:
MRIs and ultrasounds can show damage or swelling to the soft tissues, including the tendons.
An x-ray may show bone spurs, which can cause impingement syndrome. An x-ray also may show a smaller space between the shoulder bones, which suggests arthritis.
The main shoulder impingement treatments are rest and physical therapy, along with medicine to help relieve pain. Rarely does shoulder impingement require surgery.
Your doctor will tell you what movements to avoid, and for how long. If you have shoulder impingement, you should avoid throwing, lifting anything above your head, or swinging your arms high.
As your shoulder impingement heals, your physical therapist or orthopaedic doctor will introduce shoulder impingement exercises. By strengthening weaker muscles, you can relieve overused muscles. You'll also learn stretching exercises to increase the range of motion in the shoulder.
Oral nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can relieve shoulder impingement pain. Talk to your doctor about how long you should take these medicines and at what dose.
Your doctor also may suggest steroid injections into the shoulder joint to relieve swelling and pain as you recover.
Surgery is a rare treatment option for shoulder impingement. Doctors only pursue surgery when other treatments don't work.
The surgeon may need to remove a small piece of bone that is irritating the shoulder tissue. Or, they may remove or repair damaged tissue in the shoulder joint. For example, a surgeon can repair a tendon by removing the damaged part and reattaching the ends of the tendon.
You will need to wear a sling after surgery for at least a week.
Up to 90% of people with shoulder impingement improve with nonsurgical treatments. Once your doctor gives you a treatment plan, follow up with them if symptoms don't improve within 8 to 12 weeks. It can take 3 to 6 months for pain to fully resolve.
You may be a candidate for the Return to Play program if you are an athlete who has been treated for a sports injury, completed physical therapy, and is looking for additional support to help you safely and confidently reengage with your sport.
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