Impingement Syndrome

What is Impingement Syndrome?

Impingement syndrome is also called by a variety of names including swimmer’s shoulder, shoulder impingement syndrome, painful arc syndrome and subacromial impingement. Despite the common names, impingement syndrome can happen for a variety of reasons other than swimming such as painting, moving furniture, throwing a ball, playing tennis or doing home repairs.

If the arms need to go over the head a lot then impingement syndrome should be expected. Pain is caused in the shoulder area by tendons rubbing against the shoulder blade. Swelling and pain results. It can affect all people of all ages and ethnic backgrounds but active people who have suffered from shoulder injuries like shoulder bursitis are most prone to developing impingement syndrome.

What are the Symptoms of Impingement Syndrome?

Right after the injury to the shoulder, the area will swell up and may cut off some blood flow to the small blood vessels in the shoulder. The shoulder itself may or may not appear or feel swollen.

Symptoms of impingement syndrome can come on gradually but they do get worse over time if treatment is not sought. Patients suffer weakness in the affected shoulder so that they are unable to move their arms without difficulty. Putting on coats or jackets can be awkward and painful. Lifting the arm above the head or trying to scratch the back of the neck is very painful.

If the patient cannot lift the arm at all than the rotor cuff may be torn, which needs treatment at once.

Impingement Syndrome Causes

Impingement syndrome occurs as a result of problems with the rotator cuff, which is a series of muscles and tendons which attach the humerus (upper arm bone) to the scapula (shoulder blade). Next to the rotator cuff is a bone on the top of the shoulder called the acromion. On the other side of the rotator cuff is a bursa, which is a lubricating sac which aids in the movements of joints.

During impingement syndrome, the space between the acromion and the rotator cuff becomes narrower than normal. This causes the acromion to rub on the bursa and on the tendons within the rotator cuff. This causes pain, usually when the arm is raised up to shoulder height.

The reason for this narrowing is usually overuse of the shoulder, particularly in activities which cause the arms to be lifted above the head. Swimmers, baseball players and tennis players are at a particularly high risk of developing the condition, as are painters or decorators, construction workers, or people in other vocations which require the arms to be raised regularly and repetitively.

It’s also possible to develop impingement syndrome as a result of:

  • Shoulder injury
  • Bursitis (inflammation of the bursa)
  • Spurs on the acromion (bony growths)
  • Having curved or hooked acromion (usually a genetic trait)

How is Impingement Syndrome Treated?

Icing or cold therapy on the shoulder helps reduce both pain and swelling. Place cold compress, ice bag or even a bag of frozen peas for 20 minutes on the shoulder twice a day. Do not place ice directly on skin as this can cause a painful cold burn.

Over the counter NSAID painkillers like ibuprofen are often effective. Some may need to be taken with milk or food to avoid nausea. If these do not help a doctor would need to prescribe stronger painkillers. A steroid injection may help swelling and pain.

The arm needs rest and then a gradual return to daily activities. Physical therapy may be needed.

Impingement Syndrome Prevention

Individuals who are more likely to develop impingement syndrome due to taking part in a high-risk sport or having a high-risk vocation may be able to prevent the condition by strengthening their rotator cuff.

A physical therapist may be able to recommend exercises which will help to work out the rotator cuff without putting additional pressure on the muscles and tendons. They may also be able to identify other muscles or regions in the shoulders and back which are weak and could contribute to impingement syndrome. You could also consult a physical therapist for advice on the correct form so that you can complete overhead activities or arm movements without causing excessive strain on the rotator cuff.

Last Reviewed:
October 09, 2016
Last Updated:
January 18, 2018