Athletes, workers and anyone who uses their shoulder for overhead activities often suffer shoulder pain caused by excessive rubbing or squeezing (impingement) of the rotator cuff and shoulder blade. The rotator cuff is a group of muscles and tendons that stabilizes the shoulder and permits lifting and rotating movements. If the rotator cuff weakens or is injured, the bone of the upper arm can lift up, pinching the rotator cuff against the shoulder blade.

In addition to rotator cuff injuries such as tendonitis and tearing, impingement may be the result of bursitis, an inflammation of the cushioning sac between the rotator cuff and the shoulder blade. A torn rotator cuff is a potential outcome of shoulder impingement.

People most at risk for developing impingement are athletes, especially those who swim or play baseball or tennis, and people whose occupations include repetitive lifting, reaching or overhead movements, such as painting and construction.
Signs And Symptoms
At first, you may feel mild pain in the shoulder, which may radiate from the front of the shoulder to the side of the arm. The pain may worsen when you lift your arm, reach for something, or throw a ball. As impingement progresses, pain and stiffness worsen until you may not be able to lift or lower your arm.
History, physical examination, X-rays and sometimes MRI is used to diagnose shoulder impingement.


Once impingement is diagnosed, anti-inflammatory medication, activity modification, exercises and sometimes a corticosteroid injection is the recommended treatment. Sometimes a course of physical therapy is recommended. In cases where there is not enough improvement, an arthroscopic, minimally invasive, outpatient procedure to remove the inflamed bursa and bone spurs is performed to relieve the pain of impingement.