Shoulder Impingement
The pinch that starts small and stays. Break the cycle before it frays the cuff.
Overview
Understanding shoulder impingement
Impingement is a mechanical irritation: the rotator cuff tendons and their lubricating bursa get compressed in the tunnel beneath the acromion, most often because of weakness and shoulder-blade mechanics rather than a structural doom. It's the most common shoulder diagnosis — and one of the most treatable.
Left unaddressed, chronic impingement can contribute to cuff fraying, which is why persistent symptoms deserve a real program instead of a shrug.
Symptoms
What it feels like
- Pain with a specific arc of lifting the arm, especially 60–120°
- Ache along the outer arm after activity
- Night discomfort lying on the affected side
- Weak or painful reaching into a back pocket or seatbelt
Common causes
Why it happens
- Rotator cuff and scapular muscle weakness
- Repetitive overhead work or training spikes
- Posture and shoulder-blade mechanics
- Bone-spur narrowing of the outlet in some patients
Diagnosis
How it's diagnosed
Impingement is largely a clinical diagnosis — provocative tests reproduce the arc of pain. X-rays screen for spurs and arthritis; MRI enters when symptoms persist despite good rehabilitation or a tear is suspected.
Treatment
The full range of options
Non-surgical
Rehabilitation — the cornerstone
Progressive cuff and scapular strengthening resolves the great majority of impingement. This is the treatment, not the consolation prize.
Subacromial injection
A well-placed corticosteroid injection can quiet the bursa enough to let rehabilitation take hold.
Surgical
Arthroscopic decompression
For the minority who fail structured non-surgical care, removing inflamed bursa and offending spur opens the tunnel — typically outpatient with quick return to daily activity.
Recovery
The road back
Rehabilitation programs run six to twelve weeks with steady gains. After surgical decompression, daily activities resume quickly and full return typically lands in the two-to-three-month range.
Dr. Johnson's approach
Dr. Johnson treats impingement with the highest-value sequence in orthopedics: an accurate exam, a genuinely progressive rehab program, injection when it serves the program — and surgery only for the shoulders that truly need it.
Straight answers
Frequently Asked Questions
The information on this site is for education only and is not a medical diagnosis or a substitute for professional medical advice. Every patient is different — please consult Dr. Johnson or a qualified provider about your specific condition.
Ready when you are
Take the first step past shoulder impingement
A focused evaluation, an honest conversation, and a plan built for your goals.