Shoulder Impingement

What is Rotator Cuff Impingement Syndrome?

Impingement (squashing of your bodies tissues) should not occur during normal movement. When the shoulder muscles become inflamed (tendonitis) or the acromion becomes to large (arthritis) or the busae becomes to big (bursitis) the gap that exists for normal movement is reduced and no longer adequate.

What is the Impingement Zone?

Positions that significantly narrow the sub-acromial space are:

  • Your arm directly overhead.
  • Your arm working at or near shoulder height. 90-120 degrees

Shoulder Impingement


Who Suffers Impingement Syndrome?

Impingement syndrome is more likely to occur in people who engage in activities (work or sport) with repeated overhead movements such as tennis, golf, swimming or throwing a ball.

What are the Symptoms of Rotator Cuff Impingement?

  • An arc of shoulder pain 90 to 120 degrees
  • Pain that extends from the top of the shoulder to the elbow.
  • Pain when laying on the shoulder
  • Shoulder pain at rest as the condition deteriorates
  • Muscle weakness and pain when attempting to reach or lift
  • Pain when putting your hand behind you back or head.

How is Impingement Syndrome Diagnosed?

In most cases, a thorough clinical examination will identify most shoulder conditions.
Diagnostic investigations include X-rays, MRI or ultrasound scans
Shoulder pain can commonly be caused by a problem with your neck joints. Your physiotherapist should examine this area.


What Causes Rotator Cuff Impingement & Bursitis?

Rotator cuff impingement and bursitis have primary (structural) and secondary (posture & movement related) causes.

Primary Rotator Cuff Impingement – Structural Narrowing

Some of us are born with a smaller sub-acromial space. Conditions such as osteoarthritis can also cause the growth of sub-acromial bony spurs, which further narrows the space.

Secondary Rotator Cuff Impingement – Dynamic Instability

Impingement can occur if you have an unstable shoulder with movement. This means that there is a bio-mechanical fault that need to be identified.

In an unstable shoulder, the rotator cuff must work harder which can cause injury.

When your rotator cuff fails to work normally, it is unable to prevent the head of the humerus (upper arm) from riding up into the sub-acromial space, causing the bursa or tendons to be squashed.

Failure to properly treat this instability causes the injury to recur. Poor technique or bad training habits such as training too hard is also a common cause of overuse injuries, such as bursitis or tendonitis. Poor Shoulder Blade (Scapular) Stability

Scapulo-humeral pattern