Shoulder impingement — also called shoulder impingement syndrome or simply impingement syndrome — refers to a condition in which the shoulder blade compresses and pinches the rotator cuff. This pinching can cause sharp pain and general discomfort. It can also limit mobility and even disrupt sleep, among other symptoms. Shoulder pain affects many adults and is the third most common musculoskeletal pain reported in primary care settings, just after low back and knee pain.
Relief from shoulder pain is possible. Learn how to heal a shoulder impingement and what causes this common condition.
A Closer Look at Shoulder Impingement Syndrome
Shoulder impingement is typically diagnosed and addressed as a cluster of various symptoms and characteristics, and clinicians sometimes differentiate between internal and external impingement when creating a treatment plan. Regardless of type, impingement is one of the leading causes of shoulder pain worldwide, and symptoms are often chronic or recurring.
There are several reasons shoulder impingement causes that “pinched” feeling, such as:
- Rotator cuff tendinitis: Your rotator cuff is supported by four tendons, each of which can become swollen or irritated. This irritation typically builds up over a long period before it starts impacting the rotator cuff. Repeated heavy lifting above the shoulder or loose joints are two common causes of irritation. Eventually, the irritation can lead to a pinching sensation in the shoulder.
- Acromion deformity: The top of the shoulder blade — also called the acromion — is typically flat. However, some people may be born with a curved acromion or one that otherwise pinches or rubs against the rotator cuff. Others may develop bone spurs that impinge on the rotator cuff. Both can lead to discomfort and shoulder pain.
- Shoulder bursitis: The rotator cuff tendons and the shoulder blade are protected from one another by fluid-filled sacs called bursae. Repetitive shoulder motions can inflame these bursae, which may then press against and pinch the rotator cuff.
Common Causes and Risk Factors
Certain factors and lifestyle habits can make shoulder impingement more likely, even if you don’t notice symptoms right away. The pinching sensation can come on gradually until you find yourself with frequent pain, discomfort or limited mobility. Examples include:
- Repetitive overhead activities: Swimming, tennis, painting, construction work and other motions that require you to work above your head can lead to swollen tendons or bursae that may eventually put pressure on your rotator cuff and cause discomfort.
- Muscle imbalances: Weak scapular muscles can place undue strain on the shoulder blade, leading to symptoms of impingement.
- A sudden spike in shoulder activity: If the intensity, duration or frequency of an activity that requires the use of your shoulder increases beyond your body’s limits, you may experience irritation or swelling. This can develop into impingement.
- Anatomical limitations: Bone spurs and differently shaped acromions may correlate with impingement symptoms.
- Poor posture or form: If your body isn’t properly aligned when you walk, run or move, it can put excess pressure on certain parts of the shoulder or lead to overall weakness in the shoulder area from lack of strength-building activity.
Working with a medical professional can help you assess the root cause of your condition so you can find relief and reduce the risk of future issues.
Symptoms of Shoulder Impingement
If you’re trying to determine the source of your shoulder pain, consider the following shoulder impingement symptoms:
- Shoulder pain when reaching up or back: The top or outer part of the shoulder may hurt when you put on a coat, reach into a back pocket or perform similar motions.
- Night pain: Shoulder pain often worsens at night, which may disrupt your sleep and make it difficult to lie on your side.
- Weakness of the shoulder: If your shoulder begins to feel weaker than usual when you try to lift things or after using it for an extended period, you may be dealing with impingement.
If you experience these symptoms or suspect impingement or injury, it’s important to immediately cease any movement and allow your shoulder to rest. Apply a heating pad to help ease stiffness, then alternate with an icepack for 15 minutes after any activity to minimize swelling. Try to sleep on your back or the opposite shoulder so you don’t worsen symptoms. Schedule an appointment with a health care provider or physical therapist, especially if the pain is severe, gets worse or results in significant loss of function.
How to Treat Shoulder Impingement
The good news is that most minor cases of shoulder impingement are treatable without surgical intervention. Once a clinician or physical therapist has diagnosed your condition, they will work with you to develop a treatment plan that consists of strengthening and stretching exercises to help alleviate symptoms and reduce the chance of future problems. Specific recommendations will depend on the cause and location of your symptoms, but may include:
- Pendulum swings: This movement involves bending forward and letting the affected arm dangle low as you support yourself with your strong arm by leaning on a table or chair. You can then choose between three variations — rocking from one foot to the other so that your hanging arm swings in a circle, moving the arm forward and backward in a gentle arc, or moving the arm side to side in a similar arc.
- Wall slides: You’ll start this exercise by placing the hand of your affected arm flat against a wall. You will then use your fingers to walk the hand up the wall until to a pain-free height before allowing the hand to slide back down to its previous position and repeating the practice.
- Scapular squeezes: While sitting or standing, you will gently squeeze your shoulder blades back and pull them down, where you’ll hold for a few seconds before releasing. Repeat to activate and strengthen your postural muscles.
After adopting the recommended exercises, many people with shoulder impingement begin to feel better in just a few weeks. More complex cases or severe injuries may take up to six months or longer to heal.
Find Wellness With Foot & Ankle Surgical Associates
One way to reduce your chance of developing shoulder impingement — or to alleviate symptoms of the condition — is to prioritize good posture and balanced gait. Walking or running without proper alignment puts excessive stress on the wrong joints or muscle groups, which ultimately impacts how the rest of your body responds and feels.
If you’ve experienced frequent or recurring pain or discomfort in your shoulders, spine or hips, it’s time to take a closer look at your feet, ankles and overall posture. The podiatry team and physical therapists at Foot & Ankle Surgical Associates are here to provide the care, compassion and experience you deserve. We use the latest medical technology to identify any issues and recommend a treatment plan to improve your quality of life.
To learn more about our services, fill out our contact form or give us a call at 360.754.3338.
