Shoulder Impingement: Causes, Symptoms, and Effective Treatment

Joe Thwaites about to paddle surf

Paddle boarding with poor technique, shoddy equipment or a paddle of the incorrect height/flex has long being associated with shoulder problems.  In this comprehensive article, we will delve into the topic of shoulder impingement, exploring its causes, symptoms, and effective treatment options.

Understanding Shoulder Impingement

Shoulder impingement, also known as subacromial impingement, is a common condition that occurs when the tendons of the rotator cuff and the subacromial bursa become compressed or irritated within the shoulder joint. This compression leads to pain, restricted range of motion, and discomfort in the affected shoulder.

Causes of Shoulder Impingement

There are several factors that can contribute to the development of shoulder impingement. These include:

  1. Anatomical Factors: Certain structural abnormalities, such as a hooked acromion or a downward-sloping acromion, can increase the risk of impingement.

  2. Repetitive Overhead Activities: Engaging in repetitive overhead movements, such as throwing, swimming, or painting, can lead to shoulder impingement over time.

  3. Poor Posture: Maintaining poor posture, especially rounded shoulders and forward head position, can put additional stress on the shoulder joint, leading to impingement.

  4. Muscle Imbalances: Weakness or imbalances in the muscles surrounding the shoulder, particularly the rotator cuff muscles, can contribute to impingement.

Symptoms of Shoulder Impingement

Shoulder impingement is often characterized by the following symptoms:

  1. Pain: The primary symptom of shoulder impingement is persistent pain in the affected shoulder. The pain may be dull or sharp and is typically felt when raising the arm or during overhead activities.

  2. Weakness: Individuals with shoulder impingement may experience weakness in the affected shoulder, making it challenging to perform certain movements or tasks.

  3. Limited Range of Motion: Impingement can result in a decreased range of motion in the shoulder joint, making it difficult to reach or lift objects overhead.

  4. Night Pain: Some individuals may experience increased pain and discomfort during nighttime, especially when lying on the affected side.

Diagnosing Shoulder Impingement

To accurately diagnose shoulder impingement, it is essential to consult with a healthcare professional. The diagnosis typically involves a thorough physical examination, a review of medical history, and may be complemented by imaging tests such as X-rays, ultrasound, or MRI scans.

Effective Treatment Options

Fortunately, there are various effective treatment options available for shoulder impingement. The choice of treatment depends on the severity of the condition and individual circumstances. Some common treatment approaches include:

  1. Physical Therapy: A tailored physical therapy program can help strengthen the muscles surrounding the shoulder joint, improve flexibility, and correct any postural issues contributing to impingement.

  2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter NSAIDs, such as ibuprofen, can help alleviate pain and reduce inflammation associated with shoulder impingement.

  3. Corticosteroid Injections: In some cases, corticosteroid injections may be administered to provide temporary relief from pain and inflammation. These injections are typically performed under the guidance of a healthcare professional.

  4. Activity Modification: Avoiding or modifying activities that exacerbate shoulder impingement can help prevent further irritation and promote healing. This may involve temporarily ceasing overhead movements or using proper lifting techniques.

  5. Surgical Intervention: In severe cases where conservative measures fail to provide relief, surgical intervention may be considered. The specific surgical procedure will depend on the underlying cause of impingement and may involve removing bone spurs, repairing damaged tendons, or decompressing the subacromial space.

Prevention and Rehabilitation

Preventing shoulder impingement and promoting rehabilitation after treatment is crucial for long-term shoulder health. Here are some key preventive measures and rehabilitation strategies to consider:

  1. Proper Warm-Up and Stretching: Prior to engaging in any physical activity or sports, it is essential to warm up adequately and perform stretching exercises to prepare the shoulder muscles.

  2. Strength Training: Regular strength training exercises that target the muscles of the shoulder and upper back can help maintain proper muscle balance and stability, reducing the risk of impingement.

  3. Posture Correction: Maintaining good posture throughout the day, especially during prolonged sitting or sedentary activities, can help alleviate unnecessary stress on the shoulder joint.

  4. Gradual Progression: When starting a new exercise or activity, it is important to progress gradually, allowing the body time to adapt and prevent overuse injuries.

  5. Compliance with Rehabilitation Programs: If undergoing physical therapy or rehabilitation, it is crucial to follow the prescribed exercises and treatment plans to maximize recovery and prevent recurrence.


In conclusion, shoulder impingement is a common condition characterized by pain and restricted movement in the shoulder joint. By understanding its causes, recognizing the symptoms, and exploring effective treatment options, individuals can seek appropriate care and support. Remember, prevention and rehabilitation play a vital role in maintaining shoulder health and preventing future episodes of impingement. By incorporating the strategies outlined in this article, you can take proactive steps towards a pain-free and functional shoulder.