A common source of shoulder pain, especially as you age, is shoulder impingement. Left untreated, it can lead to chronic shoulder pain, especially with overhead arm movements. Read on and find out more!

​

WHAT IS SHOULDER IMPINGEMENT?

 

Impingement means something is pressing on something else - and that's exactly what happens in your shoulder with this condition. Part of your shoulder muscle tendon (called the Supraspinatus - this is one the muscles in your shoulder rotator
cuff) runs under part of your shoulder blade bone (your scapula). If there is a small bony spur in this area, or if you keep moving your shoulder tendon repititively in an awkward position, part of your shoulder blade bone can press on the tendon, and cause inflammation in the tendon.

​

Once this tendonitis (tendon inflammation) has developed, you'll start to have shoulder pain, especially with specific movements.

​

WHAT MOVEMENTS TRIGGER THIS PAIN?

 

Overhead movements with your arm internally rotated place your shoulder tendon in a position where impingement is likely to happen. Your arm goes into internal rotation when it is turned inwards - such as when you turn your arm to give a 'thumbs down' gesture.

​

CAN I TEST MYSELF TO SEE IF I HAVE SHOULDER IMPINGEMENT?

 

Definitely! Just stand up straight against a wall, put your hands straight out to either side of you, then bring them slightly forward, so they are approximately 30 degrees forwards and away from the wall (a simple way to explain this is to stand with your arms stretched out to either side against the wall, then bring them forward slightly so your arms aren't touching the wall anymore). Now rotate your arms inwards to give a 'thumbs down' gesture (like you would if someone did something bad), while keeping your elbows straight.

​

If you have pain when doing this, you may be having shoulder impingement - just see any doctor to get it checked further.

 

WHAT CAN I DO?

 

Minimise the activity that causes pain for a week or two. This typically involves any sort of overhead activity. Avoid all heavy lifting, especially if it is overhead.

 

However, you want to continue to still stretch your shoulder to prevent it from becoming stiff. If you don't raise your arm up overhead at all for 2 weeks, you'll get shoulder stiffness, and have to spend time recovering from that instead. So you
should minimise carrying loads overhead, but you should still definitely do some gentle stretches to maintain the range of motion in your shoulder. 

​

Once the pain has settled down (usually after a week or two), you can start doing some gentle stretches and strengthening exercises, check out our pages on stretching and strengthening! 

​

If the pain persists, pop down to see your friendly neighbourhood GP. He or she can prescribe you some anti-inflammatory medications which will help your pain to settle down a bit faster.

​

Your doctor can also send you for an x-ray to look for a very typical bony spur in your shoulder, or a shoulder scan to check your shoulder tendons.

 

WHAT HAPPENS IF I

LEAVE IT ALONE?

 

Impingement is a mechanical condition - part of your shoulder-blade bone is pressing on your shoulder muscle tendon, and this is causing pain. Left alone, the inflammation in the tendon may settle down on its own, provided you rest it.

​

If you do not rest your shoulder, and continue to perform the activities that cause pain, you're going to make the problem worse. If you take some painkillers, you may feel the pain is tolerable, or even resolves, but the worst thing that could happen is that you simply mask the pain but continue to damage your tendon.

​

Given enough time and mechanical abrasion, the tendon will start to tear, causing a more serious problem. Don't ignore it!

 

DO I NEED AN

OPERATION?

 

Your surgeon can remove part of the bony spur that is pressing on your tendon, thereby removing the causative factor in your shoulder impingement. This sorts the issue pretty quickly, but carries some risks.

​

When you go for shoulder surgery, you'll probably be doing it under General Anesthesia, which can be risky for some people. 

​

This is why although an operation may provide a definite fix to shoulder impingement, you should always try to manage it with some therapy exercises first. The vast majority of patients with shoulder impingement manage well without an operation, unless their bony spur is very large, or if they have a tear in their shoulder muscle tendons.

 

WRAP IT UP!

 

There are many things that can cause shoulder pain - impingement is a common one. If you have recurrent episodes of shoulder pain, try to get it checked further, and see if you need to do some x-rays, or a shoulder scan, or even see a specialist. Don't ignore your pain - you may worsen the problem in your shoulder.