Shoulder Impingement

Your shoulder is capable of a wide range of motion which also makes it prone to injury. The shoulder is a ball-and-socket joint which is surrounded by many structures including bones, muscles, tendons, and bursa – small fluid-filled sacs that decrease friction in your joints. Shoulder impingement syndrome is a painful condition described as tendinitis and/or bursitis that results from abnormal compression of the bursa and rotator cuff tendons.

Shoulder impingement syndrome is one of the most common causes of shoulder pain. It is often caused by wear and tear over time but can be accelerated with repetitive overhead activities.

Persistent shoulder impingement without proper treatment can lead to thinning of the rotator cuff which can make you more vulnerable to tears. Biceps tendinitis can sometimes accompany shoulder impingement.


  • Shoulder pain, especially with overhead activities, repetitive lifting, or when reaching behind the back
  • Pain to the touch especially on the outer shoulder
  • Pain that worsens at night or if laying on affected arm
  • Stiffness, limited range of motion, or weakness of affected limb


  • Repetitive overhead activities
  • Conditions affecting the bone such as bone spurs or arthritis

Risk Factors

  • Participating in some sports such as swimming, throwing, gymnastics, or volleyball
  • Occupations that require repetitive activity at or above shoulder level
  • Joint laxity or instability
  • Age – degeneration typically increases overtime  
  • Smoking
  • Excess weight


  • Physical examination to evaluate strength and mobility of the shoulder
  • X-ray to show bone health
  • MRI or ultrasound to show soft tissue health and determine the extent and location of the tear

Treatment Options

  • RICE therapy: Rest, Ice, Compression, Elevation
  • Nonsteroidal, anti-inflammatory medications for pain relief
  • Steroidal injections for pain relief
  • Physical therapy
  • Surgical repair may be recommended in severe cases