This content was updated for accuracy and relevance on Jan 27, 2025.
Shoulder impingement syndrome is a prevalent condition that can cause significant discomfort and restrict mobility, affecting a large portion of the population at some point in their lives.
Understanding the types of impingement, their causes, and the available treatment options is crucial for effective management and recovery, especially for those who rely heavily on shoulder mobility for their daily activities or professional tasks.
What is Shoulder Impingement Syndrome?
An impingement occurs when the soft tissue of your shoulder gets “pinched” where your collar bone (clavicle) and head of your shoulder bone (humerus) meet. This condition leads to pain during arm movements, impacting the ability to reach overhead, carry items, or even complete daily activities.
Types of Shoulder Impingement
Impingement is diagnosed as either primary, secondary, or posterior shoulder pain. These can be broken out as follows:
- Primary impingement syndrome – This type of shoulder impingement syndrome is often due to wear and tear of the shoulder.
- Secondary impingement syndrome – This results from muscle weakness or imbalance, or shoulder instability.
- Posterior or internal impingement syndrome – This is typically related to tightness in the shoulder joint capsule and affects overhead athletes, such as volleyball and tennis players.
Causes of Posterior Superior Shoulder Impingement
Posterior or superior shoulder impingement syndrome often results from specific physical activities or underlying issues. Understanding these causes is critical for effectively addressing the root of the problem.
- Repetitive overhead motions – Common among athletes like swimmers, volleyball players, and tennis players, repetitive arm movements can irritate the shoulder joint over time.
- Poor posture – Slouched or rounded shoulders can create imbalances, increasing the likelihood of impingement.
- Muscle weakness or imbalance – Weakness in the rotator cuff or scapular stabilizers can lead to instability, contributing to secondary impingement.
- Joint capsule tightness – Limited mobility in the shoulder joint capsule can restrict movement, which is often associated with posterior impingement.
- Improper biomechanics – Faulty movement patterns during sports or daily activities can place undue stress on the shoulder joint.
Diagnosing Shoulder Impingement
Different clinical tests, a thorough history, and examination will help diagnose shoulder impingement syndrome. Your doctor or physical therapist can evaluate the joint mobility of your shoulder to assess how tight the shoulder capsule is and determine the next course of treatment.
Treating Shoulder Impingement
Treatment for a shoulder posterior impingement includes stretching the muscles of your chest and neck and strengthening the muscles of the shoulder blade to bring the shoulder down and back. Treatment may include manual stretching by your physical therapist to improve shoulder mobility, if tight. However, it’s not a part of all shoulder impingement care.
Treatment will typically last 4-6 weeks to allow for muscle retraining and loosening of the shoulder capsule to occur. Some (but not all) patients will be seen for physical therapy three times a week and also prescribed a daily home exercise program for their shoulder problem. Initial soreness may be experienced, but you should let your physical therapist know if pain is increasing or if any of the exercises you are performing hurt.
If conservative treatment fails, a surgeon may go in to release the capsule to allow the shoulder to slide back and down into the joint space, although this is rare. After surgical treatment, you can expect to be in physical therapy for pain relief, range of motion, strengthening, manual therapy, and education.
Most people experience relief of symptoms and are able to return to their daily activities. Although shoulder impingement is common, it is very treatable while working closely with your healthcare professional team.
Rehabilitation Tips at Home
A well-structured home rehabilitation program is essential for managing shoulder impingement and supporting recovery. These tips can supplement your treatment plan:
- Pendulum swings – Gently sway your arm in circular motions to promote mobility without strain.
- Wall slides – To build strength and improve flexibility, Perform controlled movements of your arms up and down a wall.
- Doorway stretches – To stretch your chest and shoulders, place your arms against a doorway frame and lean forward slightly.
- Ice therapy – Apply ice to the affected shoulder after exercises to reduce inflammation and soreness.
- Consistent practice – Adhere to the daily home exercise program recommended by your physical therapist to maximize results.
Always make sure you’re following your physical therapist’s guidance to avoid overexertion or incorrect form.
Preventing Shoulder Impingement
Taking proactive steps can help you avoid posterior superior shoulder impingement and maintain shoulder health. Whether you’re an athlete or simply want to prevent discomfort, these strategies can make a difference.
- Shoulder strengthening exercises – Focus on building the rotator cuff and scapular muscles to improve stability and prevent primary and secondary impingements.
- Stretching routines – Include dynamic stretches for the chest, neck, and shoulders to combat tightness that may lead to posterior impingement.
- Postural correction – Maintain good posture, especially during prolonged sitting or desk work, to reduce unnecessary strain on the shoulder.
- Activity modification – Avoid repetitive overhead motions without adequate rest, or use proper techniques to reduce joint stress.
- Warm-ups and cool-downs – To prepare and protect the shoulder muscles, incorporate proper warm-ups before physical activities and cool-downs afterward.
Physical Therapy for Shoulder Pain
If you are experiencing shoulder pain, you have a variety of options at your disposal. At Ivy Rehab, we provide shoulder pain treatment to address the root cause and mitigate symptoms. We’ll come up with a shoulder treatment plan that suits your needs so you can begin the path to recovery. Your doctor or physical therapist will be able to answer any additional questions you may have regarding your posterior shoulder pain.
Contact us today to learn more!
