What Causes Shoulder Impingement?

Shoulder pain with reaching, lifting, exercising, or sleeping on one side is extremely common.

One possible cause is shoulder impingement, a term used to describe irritation of structures within the shoulder as they move through a relatively small space beneath the top of the shoulder.

The rotator cuff tendons and nearby bursa are commonly involved.

What Causes Shoulder Impingement?

The shoulder relies on coordinated movement between the upper arm, shoulder blade, rotator cuff, and surrounding muscles.

When this movement becomes altered, the space available for the rotator cuff and bursa can become irritated during certain motions.

Contributing factors may include repetitive overhead activity, rotator cuff weakness, poor shoulder blade mechanics, inflammation, arthritis at the acromioclavicular joint, changes in shoulder anatomy, or previous injury.

What Does It Feel Like?

Patients commonly report pain when reaching overhead or away from the body.

Symptoms may also occur while lifting weights, putting on a jacket, reaching into a cabinet, or sleeping on the affected shoulder.

Pain is often felt along the outer or front portion of the shoulder.

Some patients also notice weakness, clicking, limited motion, or discomfort when lowering the arm.

How Is It Diagnosed?

A physical examination can help assess shoulder motion, strength, rotator cuff function, areas of tenderness, and which movements reproduce symptoms.

X rays may help evaluate arthritis or bone structure, while MRI imaging can provide additional information about the rotator cuff, labrum, bursa, and other soft tissues.

Musculoskeletal ultrasound may also be useful in certain situations.

How Is Shoulder Impingement Treated?

Treatment often begins conservatively.

Physical therapy can improve rotator cuff strength, shoulder blade control, posture, and movement patterns.

Activity modification may also be necessary, particularly when repetitive or heavy overhead exercise continues to aggravate symptoms.

Depending on the underlying condition, injections or other targeted procedures may be considered.

At Ospina Medical, the goal is to identify the specific structure contributing to shoulder pain rather than treating every case of shoulder discomfort the same way.