Shoulder Impingement Treatment
Treatment for shoulder pain from tendon impingement.
Shoulder impingement occurs when the rotator cuff tendons become pinched between the arm bone and the top of the shoulder blade, usually during overhead movement. It is one of the most common causes of shoulder pain, particularly in people who do repetitive overhead activity, and most cases improve significantly with non-surgical treatment.
Types
Primary (Structural) Impingement
Caused by the natural shape or bony spurs of the shoulder blade narrowing the space for the rotator cuff.
Secondary Impingement
Caused by shoulder instability or muscle imbalance rather than bone shape.
Internal Impingement
A pattern more specific to overhead athletes, involving impingement on the inside of the joint.
Common Causes
Shoulder impingement develops when the space available for the rotator cuff tendons becomes narrowed, causing repeated friction and irritation with overhead movement.
- Repetitive overhead activity - swimming, throwing sports, and certain occupations.
- Bony spurs developing on the underside of the shoulder blade over time.
- Rotator cuff weakness allowing the arm bone to sit slightly higher than normal.
- Poor posture contributing to reduced space within the shoulder joint.
- Previous shoulder injury altering normal joint mechanics.
Signs and Symptoms
- Pain with overhead reaching or lifting the arm
- A painful arc of movement, particularly between shoulder height and just above it
- Pain that may worsen at night or when lying on the affected shoulder
- Weakness with overhead activity
- Gradual worsening of symptoms with continued repetitive activity
Diagnosis
Diagnosis is based on clinical tests that reproduce impingement symptoms during specific arm movements, sometimes supported by an X-ray or MRI to assess bone shape and rotator cuff condition.
Treatment Approach
Most cases respond well to physiotherapy focused on rotator cuff strengthening and posture correction, alongside activity modification and sometimes an injection to reduce inflammation. Surgery to create more space for the tendons is considered for the minority of cases that do not improve with sustained non-surgical treatment. Dr. K. G. Gopalakrishna reviews progress with conservative treatment before considering further options.
Please note: This page is for general information only and does not replace a proper medical evaluation. Every case is different, and the underlying cause of your symptoms may not match what is described here. Please do not use this page to self-diagnose - consult Dr. K. G. Gopalakrishna or another qualified orthopaedic specialist for an accurate diagnosis specific to you.
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Last reviewed: August 2026