Understanding Subacromial Impingement Syndrome

Shoulder impingement syndrome causes many people across various age groups and activity levels to experience shoulder discomfort and limited mobility. By grasping the cause of this syndrome, promptly identifying symptoms, and applying suitable treatment approaches, individuals can effectively address this condition, leading to an enhanced quality of life.

Dr. Benjamin W. Szerlip, DO, has many years of experience treating subacromial impingement syndrome. Book a consultation with him today to obtain a precise diagnosis for your shoulder pain and receive any necessary treatments. You can find our office in Austin, Texas.

What is Shoulder Impingement Syndrome?

Shoulder impingement syndrome (alternatively termed subacromial impingement syndrome) manifests when the tendons of the rotator cuff come into contact with the acromion, the protruding bone of the shoulder blade. This is primarily due to the balance and alignment of the shoulder blade. The repetitive friction leads to inflammation, pain, and restricted movement within the shoulder joint. 

The subacromial space, where the tendons reside, becomes narrowed, exacerbating the impingement and causing discomfort. Impingement can cause the following:

  • Rotator cuff tendinosis: Inflammation to the rotator cuff tendons
  • Subacromial bursitis: Inflammation of the subacromial bursa

Impingement can also cause problems indirectly, such as stress on the biceps tendon.

Causes of Shoulder Impingement Syndrome

Several factors contribute to the development of shoulder impingement syndrome:

  • Overuse and Repetitive Movements: Activities like swimming, tennis, painting, or weightlifting, which involve repetitive overhead motions, can strain shoulder muscles and tendons, eventually leading to impingement.
  • Muscle Weakness or Imbalance: Weakness or imbalance in the muscles around the shoulder blade or scapula, including rotator cuff muscles and scapular stabilizers, can disrupt shoulder biomechanics, heightening the risk of impingement.
  • Anatomical Variations: Structural anomalies like a hooked acromion or a downward slope of the acromion can decrease the subacromial space, making individuals more susceptible to impingement.
  • Poor Posture: Rounded shoulders or forward head posture can cause muscle imbalances, raising the chances of impingement.
  • Trauma or Injury: Direct shoulder trauma or repeated microtrauma from activities can induce inflammation and swelling in the subacromial space, leading to impingement symptoms.
  • Arthritis: Bone spurs at the acromioclavicular joint can also be responsible for decreasing the space where the tendons reside.

Symptoms of Shoulder Impingement Syndrome

Recognizing the symptoms of shoulder impingement syndrome is crucial for early intervention and effective management. Common symptoms include:

  • Pain: Persistent or intermittent pain in your shoulder, often located at the top or outer aspect of the shoulder. The pain may radiate down the arm or worsen with overhead activities.
  • Limited Range of Motion: Difficulty raising your arm overhead or reaching behind the back due to pain and stiffness in your shoulder joint.
  • Weakness: Weakness or instability in the affected shoulder, leading to difficulty performing everyday tasks or sports activities.
  • Pain at Night: Discomfort or pain that worsens at night, particularly when lying on the affected side, affecting sleep quality.
A woman receiving physical therapy for her shoulder impingement.

Diagnosis of Shoulder Impingement Syndrome

Diagnosing shoulder impingement syndrome typically involves a combination of clinical assessment, imaging studies, and physical examination. A healthcare provider or orthopedic specialist may perform the following:

  • Medical History: Gathering information about your symptoms, medical history, and activity level to assess potential risk factors for impingement.
  • Physical Examination: Evaluating your shoulder’s range of motion, strength, and stability, and performing specific tests to reproduce impingement symptoms.
  • Imaging Studies: X-rays, ultrasound, or an MRI may be requested to examine the structures of your shoulder joint and detect any structural irregularities or soft tissue injuries.

Treatment Options for Shoulder Impingement Syndrome

  • The management of shoulder impingement syndrome aims to alleviate pain, reduce inflammation, restore shoulder function, and prevent further damage to the affected tissues. Treatment options may include:

Conservative Treatments

  • Rest and Activity Modification: Temporarily avoiding activities that exacerbate symptoms and modifying daily activities to reduce strain on your shoulder joint.
  • Physical Therapy: A customized exercise regimen targeting the enhancement of rotator cuff muscles, enhancement of shoulder stability, and rectification of muscle imbalances around the shoulder blade.
  • Manual Therapy: Hands-on methods, including joint mobilization, soft tissue manipulation, and stretching aimed at enhancing shoulder mobility and alleviating discomfort.
  • Non-steroidal anti-inflammatory Drugs (NSAIDs): Over-the-counter or prescription medications to reduce pain and inflammation.
  • Corticosteroid Injections: Injections of corticosteroids into the subacromial space to reduce inflammation and alleviate pain, providing temporary relief.

Surgical Interventions

  • Arthroscopic Subacromial Decompression: A minimally invasive surgical procedure to create more space in the subacromial region by removing inflamed tissue, bone spurs, or other obstructions.
  • Rotator Cuff Repair: Surgical correction of a torn or injured rotator cuff tendon might be required for severe impingement or a rotator cuff tear.
A doctor treating subacromial impingement syndrome shoulder pain.

Recovery and Rehabilitation

The recovery process for shoulder impingement syndrome depends on the severity of the condition and the chosen treatment approach. Patients undergoing conservative treatments may experience gradual improvement over several weeks to months, with diligent adherence to rehabilitation exercises and activity modification.

For those undergoing surgical intervention, rehabilitation typically involves a structured physical therapy program aimed at restoring shoulder strength, flexibility, and function. Early mobilization, gentle stretching, and progressive strengthening exercises are integral components of post-operative rehabilitation.

Preventing Shoulder Impingement Syndrome

While shoulder impingement syndrome cannot always be completely prevented, certain measures could help reduce the risk of developing this condition:

  • Maintaining Good Posture: Practicing proper posture during daily activities and exercises to minimize strain on the shoulder joint.
  • Gradual Progression of Activities: Avoid sudden increases in training intensity or repetitive overhead movements, allowing adequate rest and recovery between sessions.
  • Strength and Conditioning: Incorporating regular strength and conditioning exercises targeting the shoulder muscles and surrounding stabilizers to improve the stability of the joint and reduce the risk of injury.
  • Proper Technique: Ensuring proper technique and form during sports activities and weightlifting exercises to minimize stress on the shoulder joint.

Book a Consultation with Dr. Szerlip Today

Don’t let shoulder pain continue to be a burden in your life. Schedule an appointment with Dr. Benjamin W. Szerlip today! He can provide you with an accurate diagnosis and tailored orthopedic treatment for a range of shoulder conditions.

Contact us to book a consultation with Dr. Szerlip in Austin, Texas. He can help you get back to a life that you love.


Medically reviewed by Benjamin W. Szerlip DO