Shoulder Impingement

Also called rotator cuff tendonitis, shoulder impingement is an injury caused by compression of tendons or bursa between the shoulder blade and arm bone. These tendons tend to rub or scrape against a part of the shoulder blade called the acromion. This rubbing or scraping may lead to abrasion or inflammation of the rotator cuff tendons. Shoulder impingement is characterized by pain, weakness and loss of motion, particularly with overhead arm movements.

The leading cause of shoulder impingement is repetitive movements that involve raising the arm above shoulder height, such as throwing or overhead lifting. Poor posture, bone spurs, arthritis and muscle imbalances can also cause impingement.

Any vocation, sport or activity that involves repetitive overhead arm movements can cause strain in the shoulder tissues. The following are high-risk activities or conditions related to shoulder impingement: 

• Sports like baseball, swimming, tennis and volleyball
• Vocations like carpentry, construction and painting
• Bone abnormalities and shoulder instability (from injury)
• Poor posture and slouching

Prevention includes avoiding repetitive overhead motions and maintaining proper posture with stretching, strengthening exercises and ergonomic modifications to equipment for sports or work.

Symptoms of shoulder impingement include pain around the shoulder blade, arm weakness, reduced range of motion and a snapping sensation during arm movement. Pain may worsen when reaching overhead or behind the back.

Shoulder impingement may be diagnosed through a physical examination by your doctor to evaluate your range of motion, strength and joint integrity. Imaging tests such as X-rays, computed tomography (CT) scans or magnetic resonance imaging (MRI) scans may be conducted to assess any damage to the shoulder joint.

Treatment involves rest, ice, medication and, in extreme cases, arthroscopic decompression or rotator cuff repair surgeries. The experts at the Montefiore Einstein Department of Physical Medicine and Rehabilitation will create an individualized treatment plan for your condition that may include: 

• Physical therapy
• Non-opioid-based pain management 
• Ultrasound-guided cortisone injections
• A personalized at-home exercise program

Most people with shoulder impingement can improve their symptoms with appropriate care and treatment. Collaborate with your physician to establish the correct diagnosis and treatment plan, incorporating physical therapy along with specific strength- and flexibility-building exercises to ensure you can return to normal activities.