Shoulder Impingement Syndrome

SHOULDER IMPINGEMENT SYNDROME

IMPINGEMENT SYNDROME: THE BASICS

What is impingement syndrome?

Shoulder impingement syndrome describes a condition in which structures in the subacromial space, meaning between the head of the upper arm bone and the shoulder roof, become mechanically narrowed. The tendons of the rotator cuff (often the supraspinatus tendon) and the bursa (subacromial bursa) are mainly affected.

Typical is pain when raising the arm between 60 and 120 degrees, the so-called "painful arc". In this range of movement, the soft tissues rub more under the shoulder roof. If this compression is repeated over weeks or months, the tissue reacts with inflammation, swelling and degenerative changes.

Important to understand:

Impingement is not a condition in its own right, but a mechanism that is triggered by different causes.

A distinction is made between:

• Primary impingement: structural narrowing (e.g. bony changes at the acromion)
• Secondary impingement: functional causes (muscular imbalances, instability, shoulder blade dysfunction)
  

Causes and risk factors

It usually develops from several factors:

Anatomical factors

• Hooked acromion (type III according to Bigliani)
• Arthritic changes in the AC joint
• Bone spurs at the shoulder roof
• Shoulder instability

Functional factors (more common!)

• Weak rotator cuff
• Shortened pectoralis major & latissimus dorsi
• Disturbed shoulder blade guidance (scapular dyskinesis)
• High position of the humeral head due to muscular imbalance
• Restricted thoracic spine mobility
• Poor posture with rounded shoulders

Load factors

• Overhead work (painters, care workers, electricians)
• Overhead sports (swimming, tennis, volleyball, throwing)
• Age 40–60 years (degenerative tendon changes)
• Previous shoulder injuries

In practice we find: The problem is usually functional, and therefore very treatable.

Symptoms and typical course

Impingement develops gradually.

Early stage

• Pain when raising the arm (painful arc)
• Pain with everyday movements (washing your hair, putting things on a shelf)
• Night pain when lying on the shoulder

Progressive

• Restriction of active mobility
• Clicking or grinding with movement
• Loss of strength from protecting the shoulder

Late stage

• Chronic inflammation of the bursa
• Weakening of the rotator cuff
• Partial or complete tears (especially supraspinatus)
• Risk of frozen shoulder

The longer you wait, the more structural problems develop.

WHAT CAN YOU DO YOURSELF?

Immediate measures for shoulder pain

• Reduce painful overhead movements (no complete immobilisation!)
• Cooling for 15–20 minutes, several times a day
• After the acute phase: heat to relax the muscles
• Pendulum exercises for gentle mobilisation
• Sleep on the healthy side, supporting the arm with a pillow

If you have numbness, tingling or marked loss of strength: get it checked by a professional.

Effective stretches

• Chest stretch in a doorway: 3×30 sec.
• Posterior capsule stretch (arm across the body): 3×30 sec.
• Levator scapulae stretch: 3×30 sec./side

Daily, pain-free, especially after screen work.

Targeted strengthening programme

Aim: centring the humeral head + a stable shoulder blade base

• External rotation with resistance band: 3×12–15
• Rowing with resistance band: 3×12–15
• Y-T-W exercise lying face down: 3 rounds

Start without weight. Control before intensity.

Posture correction and ergonomics

• Upright spine, shoulder blades "into your back pockets"
• Screen at eye level, elbows close to the body
• Ladder/aids for overhead work
• Micro-breaks with shoulder rolls and mobilisation
• Don't sleep on the affected shoulder
  

WHAT DOES PHYSIOTHERAPY AT KINEO DO?

At KINEO we work to clear values:

Evidence-based. Individual. Active. Lasting.

Differentiated diagnostics

We analyse:

• Active & passive mobility
• Painful arc, Hawkins-Kennedy, Neer test
• Shoulder blade mechanics and posture
• Rotator cuff and muscle balance
• Thoracic spine
• If needed, working with doctors for imaging

We treat not the symptom but the cause of the narrowing.

Manual therapy and mobilisation

• Joint mobilisation of the shoulder & AC joint
• Improving the subacromial space with targeted techniques
• Mobilisation of the shoulder blade & thoracic spine
• Myofascial techniques for pectoralis minor, neck, rotator cuff
• Trigger point treatment

Aim: immediate relief and better mobility.

Modern therapy concepts and physical measures

Combined individually:

• Shockwave for chronic tendon problems
• Neuromobilisation for nerve irritation
• Kinesiotaping for postural and muscle support
• Heat/cold used in a targeted way

Individual exercise programme and functional training

The heart of the therapy:

• Progressive strengthening of the rotator cuff
• Training of the shoulder blade stabilisers (serratus anterior, rhomboids)
• Functional movements close to everyday life and sport
• Proprioception and motor control
• Step-by-step progression to full capacity

You learn to control your shoulder yourself, for the long term.

Everyday advice and ergonomic adjustments

• Workstation analysis (chair, desk, mouse, screen)
• Adapting tools and work processes
• Sport-specific technique advice
• Building in micro-breaks
• Advice on pillows, bags and everyday loads

Therapy doesn't end at the treatment couch: it works in your everyday life.

BOOK YOUR SHOULDER ANALYSIS APPOINTMENT AT KINEO NOW

Pain when raising your arm?

Night pain in the shoulder?

A feeling that "something is catching"?

Don't wait until the pain becomes chronic.

Book your appointment at KINEO online now for a comprehensive shoulder analysis.

Together we'll bring your shoulder back to pain-free mobility and full function.

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