Symptoms and treatment of shoulder impingement

With summer well and truly on the way, many of us will be dusting off the sports kit or DIY equipment or out in the garden readying it for the long evenings. For some, this sudden flurry of activity can cause shoulder injuries.

Whether you’re a tennis enthusiast or a keen gardener, you might be susceptible to shoulder impingement, which is usually irritation caused to tendons in your shoulder, often due to overuse or repetitive movements, resulting initially in inflammation and pain. 

While it’s a common condition, it can worsen and lead to secondary complications such as frozen shoulder if symptoms are ignored. Luckily that’s something we can help with. 

If you have shoulder pain or you need physiotherapy in Twickenham, read on to discover the symptoms of shoulder impingement and how it is treated.

What is shoulder impingement?

Also known as rotator cuff tendonitis, the condition can be caused by long-term overuse or from repetitive arm-intensive activity such as DIY, tennis or hedge trimming. This can irritate tendons that form the band of muscle called your rotator cuff, which secures your upper arm in its socket. 

When the rotator cuff swells, the tendon and the fat pad known as a bursa, which allow your rotator cuff to move smoothly, become pinched together in the space between your shoulder blade and the arm bone.

Shoulder impingement symptoms

Signs you may have shoulder impingement include:

  • pain around the top and outside of your shoulder
  • pain radiating from the front of your shoulder to the side of your arm
  • shoulder pain or aching at night
  • pain when lying on your shoulder
  • sudden pain when lifting and reaching e.g. when throwing or serving a tennis ball.

Causes of shoulder impingement

Causes of shoulder impingement include:

  • bursitis — the bursae or ‘cushions’ between your rotator cuff and the outer edge of your shoulder blade (the acromion) become inflamed because of injury or overuse
  • age-related wear and tear 
  • bony spurs on the acromion or an irregular or misshapen acromion, which reduces the space needed by your rotator cuff and causes pinching or trapping of the cuff when your arm is raised
  • bony growths or ‘spurs’ on the acromion, which can develop as you get older.
  • repetitive overhead activity
  • sustained poor desk posture
  • degeneration of the rotator cuff tendons due to use or age

How to treat shoulder impingement

Modify your activity

If you suspect you have shoulder impingement, you should stop any activities that involve unnecessarily lifting or raising of your arm. However, don’t avoid using your shoulder altogether; try to complete daily activities to prevent it becoming stiff and weak.

Apply ice packs

Apply ice packs or frozen peas to bring down any swelling. Do this several times a day for about 10 minutes. Don’t burn yourself!


Seek advice regarding anti-inflammatory painkillers, such as ibuprofen, from your pharmacist. Stronger medication can be prescribed by a doctor if necessary.


Gentle stretches and exercises advised by a physiotherapist can help increase your range of movement gradually and safely. It also helps to increase blood flow, and reduce inflammation and damage, while lessening your pain and helping build strength in your muscles.


For more serious cases, you might need keyhole surgery to increase the space around your rotator cuff and stop it from catching or rubbing against anything. It can be carried out under general anaesthetic and, in most cases, you’ll be allowed home on the same day as your surgery.

Recovery can take from 3 to 6 months. You will need physiotherapy to help rebuild the strength in your shoulder and gradually increase its range of flexibility and movement.

If you think you’re experiencing shoulder impingement, feel free to give us a call on 0208 898 1213 to discuss your symptoms and treatment.

Remember, for a more specific diagnosis and treatment advice, you’ll need an assessment from a professional.