Shoulder Impingement

Shoulder impingement is commonly caused by repetitive overhead movements, leading to wear and tear on the shoulder’s soft tissues. Athletes who engage in sports requiring frequent arm movements above shoulder height, such as swimming, tennis, and baseball, are at a higher risk. Occupations that involve repetitive lifting or reaching, such as painting or construction, also contribute to impingement.
Poor posture, such as slouching or rounded shoulders, can exacerbate shoulder impingement by altering the position of the shoulder blade, reducing space for the rotator cuff tendons. Age-related degeneration and conditions such as bone spurs or arthritis can further narrow the space in the shoulder joint, increasing the risk of impingement.
Weakness or imbalance in the shoulder muscles, particularly the rotator cuff, can also contribute to impingement. When the rotator cuff lacks strength, it may not adequately stabilise the shoulder joint, resulting in excessive movement that places strain on the tendons and bursa.

Diagnosing shoulder impingement involves a physical examination and an assessment of symptoms, including pain patterns and range of motion. The clinician may perform specific tests, such as the “Neer test” or “Hawkins-Kennedy test,” to reproduce impingement symptoms and assess shoulder flexibility.
Imaging tests, including X-rays, MRI, and ultrasound, are commonly used to confirm the diagnosis and assess the severity of the condition. X-rays provide a view of the bone structure and can identify potential contributors, such as bone spurs or arthritis. MRI offers detailed imaging of the soft tissues, allowing the clinician to assess the rotator cuff tendons, bursa, and surrounding muscles. Ultrasound is particularly useful for evaluating real-time movement in the shoulder joint and detecting inflammation in the tendons or bursa.
In cases where additional assessment is needed, diagnostic injections with anaesthetics may be used to confirm the source of pain by temporarily relieving discomfort in the affected area.

Treatment for shoulder impingement focuses on reducing inflammation, relieving pain, and restoring shoulder function. Initial treatment typically includes rest, ice application, and anti-inflammatory medications to manage mild pain and swelling. Avoiding activities that aggravate the shoulder, particularly overhead movements, is crucial for allowing the area to heal.
Physical therapy is a key component of recovery, with exercises to improve shoulder flexibility, strengthen the rotator cuff, and correct posture. Stretching exercises targeting the shoulder muscles can relieve tightness and improve joint mobility, while strengthening routines help stabilise the shoulder. For individuals with poor posture, ergonomic adjustments may be recommended to reduce strain on the shoulder joint.
In cases where pain persists or inflammation is significant, corticosteroid injections may be used to reduce swelling and provide temporary pain relief. In severe cases, where conservative treatments do not improve symptoms, arthroscopic surgery may be considered to remove bone spurs or increase the space in the shoulder joint. Post-surgical rehabilitation is essential for regaining shoulder strength and function.

Booking an initial consultation at The Clinica is the first step toward diagnosing and managing shoulder impingement effectively. During this appointment, our specialist will perform a detailed assessment, discussing your symptoms and reviewing your medical history to determine potential contributing factors. A physical examination of the shoulder joint will help identify the cause and severity of impingement.
If necessary, imaging tests such as X-rays, MRI, or ultrasound will be arranged to confirm the diagnosis and guide treatment. Based on these findings, a personalised treatment plan will be developed, focusing on pain relief, rehabilitation, and strategies to prevent recurrence, ensuring a structured approach to recovery and shoulder health.