Shoulder Impingement
Impingement described as a tissue at the top of the shoulder being compressed as the arm lifts, producing a distinct pinch through the middle of the movement. The term has fallen out of favour clinically, because it names a mechanism rather than a diagnosis and the underlying problem is usually cuff-related. Either way, the treatment is well established and it does not begin with surgery.
What causes it
- Weakness through the rotator cuff and shoulder blade muscles
- A rapid increase in overhead loading
- Stiffness in the upper back reducing how far the shoulder blade can rotate
- Swelling in the tendon or bursa reducing the available space
- Bony shape at the top of the shoulder, which some people simply have
What you might notice
- A painful arc roughly between shoulder height and overhead
- Pain reaching into a cupboard or putting on a seatbelt
- Discomfort at the front and outside of the shoulder
- Night pain lying on that side
- A sense of catching rather than true weakness
How we treat it
- Cuff and shoulder blade strengthening, which changes the mechanics
- Upper back mobility work so the shoulder blade can move properly
- Manual therapy to settle the irritated tissue
- Temporary modification of overhead load rather than avoidance
- Technique review for the sport or task that provoked it
- Referral for imaging only where it would change the plan
This page is general information, not a diagnosis. Symptoms overlap between conditions, so the right treatment depends on an assessment. If your pain followed a significant injury, is getting worse, or comes with numbness, weakness or unexplained weight loss, please see your GP.
Worth checking what is actually being pinched
Impingement is a description, not a diagnosis. Finding out which tissue is irritated and why is what makes the difference between a plan and guesswork.
Or call us on (08) 7008 7566 — we see patients across Seaton, Modbury and Stepney.
177 Trimmer Parade, Seaton SA 5023
(08) 7008 7566
physio@upplus.com.au