Shoulder Impingement

Shoulder impingement, also known as subacromial impingement or subacromial bursitis, is a condition characterised by compression or pinching of the tendons and soft tissues in the shoulder joint. It occurs when there is reduced space between the acromion (a bony projection of the shoulder blade) and the rotator cuff tendons and bursa (fluid-filled sacs that cushion the joint). This compression can lead to irritation, inflammation, and pain.

The main causes of shoulder impingement include:

  1. Structural factors: Certain anatomical variations, such as a hooked acromion, a downward-pointing acromion, or a narrow space beneath the acromion, can increase the risk of impingement. A rotator cuff tear can also be a cause.
  2. Repetitive overhead activities: Activities that involve repetitive overhead motions or excessive use of the shoulder joint can contribute to the development of shoulder impingement.
  3. Muscle imbalances and weakness: Imbalances in the muscles surrounding the shoulder joint and the scapula can lead to improper movement patterns and shoulder mechanics, increasing the risk of impingement.

The symptoms of shoulder impingement may include:

  1. Pain or aching in the shoulder, especially during overhead activities or reaching behind the back.
  2. Weakness or difficulty in lifting objects or performing certain movements.
  3. Limited range of motion, particularly in activities involving abduction (raising the arm to the side) and external rotation (rotating the arm outward).
  4. Tenderness and swelling in the front or side of the shoulder.


    subacromial bursa

    Subacromial Bursa

    The subacromial bursa is a fluid filled cavity that lies under the acromion and the deltoid muscle. It allows the underlying rotator cuff tendons to slide smoothly past the acromion.

    subacromial bursitis

    Subacromial Bursitis

    The subacromial bursa may become inflammed and painful in conditions affecting the shoulder, such as rotator cuff tears, external compression or muscle imbalance.

    subacromial spur impingement

    Acromial Spur

    The subacromial bursa may become inflammed and painful in cases of extrinsic compression of the rotator cuff muscles, such as an acromial spur.


    Treatment for shoulder impingement typically involves a combination of conservative measures, including:

    1. Rest and activity modification: Avoiding or modifying activities that worsen symptoms.
    2. Physical therapy: Strengthening exercises to improve shoulder stability, flexibility exercises, and postural correction.
    3. Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections to reduce pain and inflammation.
    4. Modification of technique or equipment: Adjusting the technique or equipment used during sports or repetitive activities to reduce shoulder strain.
    5. In some cases, if conservative measures do not provide sufficient relief, surgery may be considered to create more space in the shoulder joint and address any structural issues causing impingement.

    Get Expert Help

    Symptoms with shoulder bursitis or impingement can vary from patient to patient. If you are experiencing shoulder pain, limited mobility, or other concerning symptoms, Dr. Arthur Turow can assess your shoulder, provide you with an accurate diagnosis and suggest tailored treatment options specific for your individual needs.

    Please use above information as a guide only. More detailed information specific to your condition and your recovery will be given in your consultation with Dr. Arthur Turow, who will also provide additional resources to supplement your discussion. For more information, please contact the rooms of Dr. Arthur Turow on (08) 8236 4179.