Shoulder Impingement Syndrome: Causes, Symptoms, Prevention

Shoulder Impingement Syndrome: Causes, Symptoms, Prevention

What is Shoulder Impingement Syndrome?

Impingement syndrome is a condition of the shoulder that includes several other diagnoses including subacromial bursitis and rotator cuff tendinitis. We commonly hear these referred to as pitcher’s shoulder, swimmer’s shoulder or rotator cuff tear.

What Causes Shoulder Impingement Syndrome?

Physical causes:

The most common physical cause of impingement syndrome is repeated overhead motion of the shoulder (particularly in abduction and flexion). Some people may experience syptoms from a simple strain of the shoulder muscles. These muscles and tendons can become inflamed or impinged by the bony anatomy of the shoulder. If not corrected this may lead to tears or a rupture of the tendons of the rotator cuff, most commonly the supraspinatus tendon. This is due to the lessened blood flow to the tendon attachment on the arm.

What Causes Bursitis?

Medical cause:

Repeated overhead motion or strain stresses the muscles and tendons of the rotator cuff. The inflammatory process begins and decreases the space needed for proper function of the shoulder complex. Most often bursitis (link to other condition) develops, further reducing the usable space for movement.

What are the Symptoms of Shoulder Impingement Syndrome?

The most common symptom associated with impingement syndrome is shoulder pain. The pain is worse when moving the arm overhead from about 60 to 120 degrees. If this continues the problem may persist and become painful at rest too, which indicates tendinitis has set in. This symptom is typically worse at night. If the condition progresses to a tear it may be difficult or impossible to rotate the arm outward.

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How to Prevent Shoulder Impingement Syndrome?

Being aware that activities you perform on a regular basis may be putting you at risk is the key to prevention. A good start is to:

  • Avoid postures that put awkward stresses on the shoulder for extended periods of time.
  • Control inflammation with rest, ice and a sound mobility health routine.
  • Have your work station checked for ergonomic risks if the condition is work-caused or related.
  • Start training slowly and make gradual increases over time, especially if you are an older adult.
  • Stop smoking

Shoulder Impingement Syndrome Prevention Pathway


Ergonomic Hygiene

The art and science of adapting your physical workspace and surroundings to function best with your specific needs.

Ergonomic Hygiene

Proper posture, position and motion are critical to prevention. It impossible to achieve any of these without the proper workstation setup and healthy mobility.

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Mobility Health

The practice of performing mobilization and exercises to maintain proper functioning of the musculoskeletal system (joints, muscles and everything connecting them).


Warm-ups, stretches and strengthening exercises specifically designed to address risks to your mobility health from your environment (work and home).

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Injury and strain due to fatigue is very common and avoidable with proper rest intervals. Microbreaks during activities decrease injury risks.


It doesn’t take a lot of downtime to allow your body to recover and reset. Depending on the activity rest may just be one minute for every twenty minutes of activity.

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How is Shoulder Impingement Syndrome Treated?

Most cases of impingement syndrome are treated with self care or at home therapy. Conservative treatment has been shown to yield satisfactory results in 60% of individuals

Stretching with a slow progression to exercises are important to improve the strength of the rotator cuff muscles. Ice and OTC medications may be beneficial for reducing pain and inflammation in the shoulder. Some people experiencing severe symptoms may require a corticosteroid injection to kickstart the healing process. Avoiding or reducing aggravating activities helps to stop or lessen further irritation to the area.

The shoulder is a complex joint with several components making it up. These include:

  • Rotator cuff muscles
    • Supraspinatus
    • Infraspinatus
    • Teres minor
    • Subscapularis
  • Biceps tendon
  • Joint capsule and ligaments
  • Labrum
  • Bones
    • Scapula
    • Clavicle
    • Humerus
How is Bursitis Treated?

The True Cost of Shoulder Impingement Syndrome?

  • To You: direct costs of maximizing insurance deductibles and out of pocket max plus the costs of reduced quality of life, lost productivity due to time away from work, and potential disability.
  • To Employers: direct costs of up to $46,000 per case plus the cost of quality, lost productivity, absenteeism, and turnover.
  • To the U.S. Economy: direct care costs over $300 billion every year plus the costs of lost productivity and disability.

How Common is Shoulder Impingement Syndrome?

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FAQs About Shoulder Impingement Syndrome

Conservative care including corrective stretches and exercise and OTC medications can run from hundreds to a few thousand dollars. Shoulder impingement surgery starts at about $8,000 for minor cases while more serious issues can cost over $18,000.

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