Shoulder Impingement

Known by a variety of names such as rotator cuff
tendinitis, swimmers shoulder, throwers shoulder
subacromial impingement or subacromial bursitis,
this clinical syndrome occurs when the rotator cuff
tendons become irritated and inflamed as they
pass through the subacromial space.


This can be an overuse injury due to repetitive or
prolonged strain on the rotator cuff tendons such
as with overhead activities, pulling/pushing, lifting
or repetitive reaching. It can also be the result of a
direct blow or fall onto the point of the shoulder
forcing the head of the humerus upwards into
the subacromial space creating a pinching effect on the rotator cuff tendon.


Depending on the severity, patients will often
present with one or more of the following:

  • Painful arc of movement (usually during
    movements above shoulder height)
  • Difficulty reaching up behind back (i.e.
    females may struggle doing up their bra)
  • Weakness of certain movements
  • Loss of range of movement
  • Inability to sleep on the affected shoulder
  • Associated neck pain

Physiotherapy is a vital tool for treating
impingement syndrome. Some treatment
techniques may include:

  • Soft tissue massage: Targeted at tight,
    over worked muscles particularly at the
    back of the shoulder.
  • Activity Modification: Avoiding
    aggravating positions such as repetitive
    overhead movements
  • Dry Needling/Acupuncture: To loosen
    tight bands within overactive muscles
  • Rehabilitation using specific strengthening
    to address weakness/muscle imbalance
    around the shoulder. (eg: rotator cuff
    strengthening / scapular retraction
  • Electrophysical therapy: to assist with
    reducing inflammation and pain

To effectively treat this problem specific factors
contributing to the problem must be addressed:
Such issues include muscle weakness or
incoordination, soft tissue tightness, impaired
scapulohumeral rhythm and training errors.

In circumstances where conservative management
fails to provide relief of symptoms there are
alternative options such as cortisone injections,
PRP (Platelet‐rich plasma) and in more severe
cases surgery.

Ross and Emma, the physiotherapists for Easts
Rugby, specialise in the treatment of
musculoskeletal injuries. If you would like to make
an appointment please contact us on 9328 3822

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