Shoulder impingement is essentially a tendinopathy (a tendon disorder that results in pain, swelling and impaired function – tendonitis) of the rotator cuff tendons. When the rotator cuff muscles are not functioning correctly there is an upward displacement of the humeral head. This then causes an impingement of the humeral head against the acromion process of the scapula, trapping the rotator cuff tendons (Dr Rod Whiteley – Physio Network Masterclass 2020). Shoulder impingement is generally found in swimmers, people that undertaken activities overhead such as throwing, racquet sports and even painting.

Many suffering from impingement find that it is painful to lay on the affected shoulder at night as the compression of the tendons increases with the body weight also going through the joint. They may also experience a constant ache in the arm, difficulty reaching up behind the back, pain on overhead movements and weakness. There would be a positive Neer impingement sign (where the scapula is stablised and the arm forced into forward flexion) however this test will also cause pain in other should conditions. An injection into the subacromial space may remove the pain during this test which would indicate impingement. If you want to learn more about the structure of the shoulder region head over to our previous blog on the
“Shoulder Region“.

Standard rotator cuff exercises where the arm is by the side of the body will often aggravate the condition due to the position of the tendons. With the arm by our side, the tendons of the rotator cuff turn from approximately horizontal at their origin in the muscle bellies to a more vertical position as they travel towards their insertions on the humerus.

Commencing strengthening exercises may be best performed in a sidelying or supine position and with the arm at 90 degrees of abduction. You can then progress them by creating a load through the use of Theraband or tubing that you are working against to raise the weight.