Shoulder Impingement Syndrome: What It Is and How to Fix It

Shoulder pain is a common complaint—especially among athletes, manual workers, and people who spend long hours at a desk. One of the most frequent causes is Shoulder Impingement Syndrome, a condition that can cause discomfort, limited mobility, and difficulty with overhead activities.

In this blog, we’ll explain what shoulder impingement is, how it develops, what symptoms to look out for, and most importantly—how to fix it.

What Is Shoulder Impingement Syndrome?

Shoulder impingement syndrome occurs when the rotator cuff tendons or the subacromial bursa become pinched between the top of the shoulder blade (acromion) and the upper arm bone (humerus). This space is known as the subacromial space, and when it narrows due to inflammation, bone spurs, or poor movement mechanics, it leads to irritation and pain.

What Causes Shoulder Impingement?

Several factors can contribute to impingement, including:

• Repetitive overhead movement (e.g. throwing, swimming, weightlifting)

• Poor posture, especially rounded shoulders

• Weakness or imbalance in shoulder muscles

• Bone spurs or acromial shape that reduces subacromial space

• Previous shoulder injury or instability

It's particularly common in overhead athletes, office workers with poor posture, and people performing manual or repetitive work.

Symptoms of Shoulder Impingement

Shoulder impingement typically develops gradually but can worsen if left untreated.

Key Symptoms Include:

• Pain when lifting your arm, especially above shoulder height

• Discomfort during or after overhead activity

• Night pain, especially when lying on the affected side

• Weakness or limited range of motion

• A catching or grinding sensation in the shoulder

If ignored, impingement can lead to rotator cuff tears or chronic tendonitis.

Diagnosing Shoulder Impingement

A clinical diagnosis is often made through a physical exam, including tests like:

• Neer’s test

• Hawkins-Kennedy test

• Painful arc test

Imaging such as X-rays may show bone spurs or acromial shape, while MRI or ultrasound can assess tendon health, bursal inflammation, or confirm other pathology like a rotator cuff tear.

How to Fix Shoulder Impingement

1. Activity Modification

Reduce or avoid painful overhead motions temporarily. Adjust your workspace or technique in sport to avoid aggravating movements.

2. Physiotherapy

The foundation of treatment, physiotherapy focuses on:

• Postural correction

• Scapular stabilisation

• Rotator cuff strengthening

• Shoulder mobility and control

Targeted rehab restores the mechanics of the shoulder joint, often resolving the issue without invasive treatment.

3. Anti-inflammatory Treatment

To reduce pain and swelling:

• Ice therapy

• NSAIDs (if appropriate)

• Corticosteroid injection (in resistant cases)

These treatments are best used alongside rehab—not as a substitute.

4. Shockwave Therapy or Ultrasound Therapy

These non-invasive modalities may help in chronic cases where soft tissue is thickened or inflamed.

5. Surgery (If Conservative Treatment Fails)

In rare cases, particularly if there’s structural narrowing, bone spurs, or a rotator cuff tear, arthroscopic surgery may be needed to:

• Remove bone spurs (acromioplasty)

• Repair the rotator cuff

• Debride inflamed tissue

Recovery from surgery involves a structured rehabilitation programme over 3–6 months.

Preventing Shoulder Impingement

You can reduce your risk of developing impingement with a few key strategies:

• ✅ Maintain upright posture and avoid slouching

• ✅ Strengthen your shoulder blade and rotator cuff muscles

• ✅ Warm up thoroughly before sports or workouts

• ✅ Avoid overtraining, especially in overhead positions

• ✅ Take regular breaks if working at a desk or lifting repetitively

Frequently Asked Questions (FAQ)

Is shoulder impingement a serious condition?
While not life-threatening, it can significantly impact quality of life. If ignored, it may lead to rotator cuff tears or chronic pain.

Can shoulder impingement heal on its own?
Mild cases may improve with rest and exercise. However, proper rehabilitation is often needed to correct the mechanics causing the problem.

How long does recovery take?
With physiotherapy, most cases resolve within 6–12 weeks. Chronic or complex cases may take longer.

Do I need surgery for shoulder impingement?
Only if conservative treatment fails. Most patients respond well to non-surgical approaches.

Can I still train at the gym with impingement?
You may need to modify exercises and avoid overhead lifting. A physiotherapist can guide safe training alternatives.

Final Thoughts

Shoulder impingement syndrome is highly treatable, especially when addressed early. With the right rehabilitation, most people can fully recover without the need for surgery. Whether you’re an athlete, active professional, or simply struggling with day-to-day shoulder pain, seeking professional assessment and tailored therapy is the key to long-term relief.

Need help managing shoulder pain?
Book an assessment with our musculoskeletal experts at MSK Doctors—no GP referral needed. Our team combines advanced diagnostics with evidence-based treatment to help you recover and return to full function.