Shoulder Impingement

What is Shoulder Impingement Syndrome?

Shoulder impingement occurs when the tendons of the rotator cuff or the bursa become pinched between the bones of the shoulder during movement. It’s one of the most common causes of shoulder pain, especially in athletes who perform overhead movements such as swimmers, throwers, or weightlifters.

Common Symptoms

• Pain with reaching overhead, behind the back, or across the body

• A “painful arc” of motion, typically between 60–120 degrees of elevation

• Weakness or fatigue in the shoulder with repeated activity

• Night pain, especially when lying on the affected shoulder

Physical Therapy Diagnosis

A PT will evaluate posture, shoulder and scapular movement, range of motion, and rotator cuff strength. Special clinical tests such as Neer’s or Hawkins-Kennedy may reproduce symptoms. Manual palpation and mobility assessments help confirm areas of tightness or dysfunction.

Why it Happens

Impingement typically develops from poor posture, altered shoulder mechanics, or muscular imbalances. Repetitive overhead activity in sports or daily life increases stress on the rotator cuff and surrounding tissues, leading to irritation.

Why it Doesn’t Always Heal on Its Own

Rest may temporarily reduce symptoms, but the underlying causes—such as poor movement patterns, weakness, or postural issues—often persist. Without intervention, impingement can progress to tendonitis or even rotator cuff tears.

Ideal Physical Therapy Treatment

Effective treatment focuses on restoring mechanics, improving posture, and building shoulder stability. Dry needling can help reduce muscular tension in the rotator cuff and upper back to relieve stress on the joint.

Key strategies include:

• Manual therapy to improve shoulder and thoracic mobility

• Dry needling for rotator cuff, deltoid, or upper back muscle tightness

• Targeted strengthening of the rotator cuff and scapular stabilizers

• Postural and movement retraining to improve alignment and reduce impingement risk

• Activity modification and education on safe overhead movement

Expected Outcomes

With consistent rehab, most athletes and active adults experience significant improvement within weeks. Proper strengthening and retraining reduce recurrence and help prevent progression to more severe shoulder conditions.