Shoulder impingement

Shoulder impingement is one of the most common causes of shoulder pain, and it can turn everyday tasks like reaching overhead, lifting objects or sleeping on your side into a real challenge. It happens when the tendons and soft tissues inside the shoulder joint become irritated and compressed. With the right care, most people find relief and get back to moving comfortably.

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A detailed view of shoulder muscles showing tendons and bones.

Anatomy of the shoulder

The shoulder is a ball-and-socket joint built for a wide range of motion. The ball-shaped head of your upper arm bone, called the humerus, fits into a shallow socket called the glenoid, which is part of your shoulder blade. This design lets your arm move freely in many directions, but it also depends heavily on muscles, tendons and soft tissues for stability.

The rotator cuff tendons and a fluid-filled cushion called the bursa help your shoulder move smoothly through that range of motion. When these structures become irritated or inflamed, the space within the joint narrows, leading to pain and limited movement, the hallmark of shoulder impingement.

Overview

Symptoms

Symptoms of shoulder impingement often develop gradually and can vary in intensity. Common signs include:

Shoulder pain at rest and during activity
Pain that worsens when lifting the arm or reaching overhead
Weakness in the affected arm
Difficulty performing daily tasks, such as dressing or reaching shelves
Discomfort that may interfere with sleep

If left untreated, shoulder impingement can lead to increasing pain and reduced shoulder function over time.

Causes

Shoulder impingement often develops in young and middle-aged adults who engage in activities that require repeated overhead arm use. It's sometimes called swimmer's shoulder, tennis shoulder or rotator cuff tendinitis because of how often it affects people who perform repetitive overhead motions. Common causes include:

Repetitive overhead movements in sports or work
Tendinitis of the rotator cuff
Bursitis, or inflammation of the bursa overlying the rotator cuff
Partial tears of the rotator cuff tendons
Poor shoulder mechanics or muscle imbalance

Ongoing irritation can worsen symptoms over time if the underlying cause isn't addressed.

Risk factors

Certain activities and habits can raise your chances of developing shoulder impingement, though having one or more of these factors doesn't mean you'll develop the condition. Risk factors include:

Jobs or sports that require repeated overhead reaching or throwing
Poor posture or muscle imbalances around the shoulder blade
Previous shoulder injury
Age-related changes in the tendons and bursa

Your care team can help you understand your personal risk and how to protect your shoulder health.

Diagnosis

Diagnosis begins with a thorough physical examination, during which your care team evaluates your shoulder's range of motion, strength and pain patterns. Your medical history and activity level also help explain how the condition developed.

Imaging studies may confirm the diagnosis and show the extent of inflammation or injury:

X-rays to evaluate bone structure and rule out other causes of pain
MRI scans to visualize soft tissues, including the rotator cuff and bursa

We explain your results clearly so you understand your condition and your options moving forward.

Diagram showing a torn supraspinatus tendon.

Common causes of shoulder pain

Understand the common causes of shoulder pain, including rotator cuff injuries and labral tears, and the surgical treatment options that may be available.

Videos in our patient education library are available to help you gain a general understanding of the condition or procedure. Read disclaimer.

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