Shoulder pain – Impingement Syndrome

Shoulder pain is a vast topic, and could be diagnosed as many different conditions. Many shoulder pain sufferers report pain with overhead movements. Examples include dumbbell shoulder press, hanging clothes on the line, or serving in tennis. Shoulder impingement syndrome is one of the most common causes of shoulder pain in sports people and desk workers.

Impingement syndrome can occur secondary to trauma to the shoulder but more commonly it occurs due to chronically held postures as observed in desk workers, but also in racket sports such as tennis and squash, or throwing sports such as cricket and baseball. Muscular imbalances and repetitive movements involved in these scenarios lead to aberrant joint mechanics in the shoulder, which ultimately develop into pain and reduced motion at the shoulder.

Basic shoulder anatomy

The shoulder joint is complex, when referring to shoulder impingement; people are most commonly referring impingement under the acromioclavicular joint or AC joint. The AC joint is made up of the proximal end of the acromion and the distal end of the clavicle (collar bone). Under the acromion there is the sub-acromial space, through this space runs three tendons of the rotator cuff, the long head of the biceps tendon and the subacromial bursa. When we perform overhead movements or have a slouched postured the size of this space decreases and the contents of the space can become compressed and irritated, leading the impingement symptoms (2).

Symptoms of shoulder impingement

The symptoms vary from person to person and with the degree of impingement.

Symptoms include

shoulder pain
  • Pain on the anterior (front) or lateral (side) aspect of the shoulder Painfularc
  • Pain with overhead activities
  • Pain with repetitive movements
  • Pain with shoulder abduction painful arch
  • Popping or clicking in the shoulder
  • Weakness
  • Night pain
  • Pain relieved by rest or postural change (2)(3)


Fortunately shoulder impingement can be treated successfully by conservative (non surgical) treatment. At Cartwright physical therapy we pride ourselves on our wide variety of treatment options.

  • Soft tissue work – Massage, active release technique
  • Dry needling
  • Joint mobilization
  • Joint manipulation
  • Individualised rehabilitation program for more information on exercises that are prescribed you can read our previous blog post on shoulder exercises

If you have any questions on shoulder pain or are suffering from shoulder pain or any other type of pain come in and see us or book an appointment today on 02 99226116 or visit our clinic at “Walker House”, Level 3, Suite 304, 161 Walker Street North Sydney for more information.

By Patrick Lind

*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.

  1. Pribicevic M, Pollard H, Bonello R. An epidemiologic survey of shoulder pain in chiropractic practice in australia. J Manipulative Physiol Ther. 2009;32(2):107-17.
  2. Seitz AL, McClure PW, Finucane S, Boardman ND, 3rd, Michener LA. Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both? Clinical biomechanics (Bristol, Avon). 2011;26(1):1-12.
  3. Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg. 2009;18(1):138-60.

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