Shoulder Impingement

Impingement, also called impingement syndrome, is caused by the excessive squeezing or rubbing of the rotator cuff and shoulder blade. The pain associated with the syndrome is a result of an inflamed bursa (lubricating sac) over the rotator cuff, and/or inflammation of the rotator cuff tendons, and/or calcium deposits in tendons due to wear and tear. Shoulder impingement syndrome can lead to a torn rotator cuff.

Repeated activity, such as overhead use of the shoulder, is a risk factor for shoulder impingement. Examples of activities that can lead to impingement include: painting, lifting, swimming, tennis, and other overhead sports. Other risk factors include bone and joint abnormalities. However, most impingement results from muscle imbalance around the shoulder, and occurs in people with no special risk factors or injury.

What are Symptoms of Impingement

Symptoms of impingement include:

  • difficulty reaching up behind the back
  • pain with overhead use of the arm
  • weakness of shoulder muscles

The tendons of the shoulder can actually tear in two, and if they had been injured for a long period of time, can result in a rotator cuff tear. This can cause weakness that can make it difficult to raise the arm.

How is Impingement Diagnosed?

The most effective tools for diagnosing are a detailed medical history and a knowledgeable physical exam. An X-ray is the most effective imaging study to rule out bone and joint conditions such as arthritis.

How is Impingement Treated?

Specific treatment option for impingement will be based on:

  • Age, overall health, and medical history
  • Extent and duration of the condition
  • Tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Opinion or preference of the patient

Treatment may include:

  • Strengthening and stretching exercises
  • Rest
  • Nonsteroidal anti-inflammatory medications
  • Ultrasound therapy
  • Corticosteroid injection

Most patients with impingement are successfully treated with physical therapy to improve the balance of muscles around the shoulder. Medication can sometimes be helpful, as is temporary avoidance of repetitive overhead activity until the condition settles down. If these treatments are not effective and if impingement has led to a torn rotator cuff, surgery may be required.

Watch this animated rotator cuff repair.

Impingement Treatment at Brigham and Women’s Hospital

Surgeons in the Department of Orthopaedic Surgery at Brigham and Women’s Hospital provide unique, innovative and comprehensive diagnosis, treatment and management for impingement and a wide spectrum of other bone and joint diseases.

In addition to impingement, Brigham and Women’s Hospital Shoulder Repair Service surgeons treat the full spectrum of shoulder conditions helping thousands of patients every year.

Bone and Joint Care at Brigham and Women’s Hospital

The Orthopaedic & Arthritis Center at Brigham and Women’s Hospital is one of the most highly regarded orthopaedic and joint disease research and treatment programs in the world. Comprehensive and innovative bone and joint care is the foundation of the Center, beginning nearly a century ago when one of our founding hospitals, the Robert Breck Brigham Hospital, became the first teaching hospital in the country wholly devoted to arthritis and related diseases.

Today, the Center – a collaboration of the Department of Orthopaedic Surgery and the Division of Rheumatology, Immunology and Allergy - is known for its pioneering team of physicians and researchers dedicated to doing everything possible for our patients while helping to develop and apply the most advanced treatments for bone and joint diseases and conditions.

Patient- and Family-centered Care
BWH has long been committed to not only the care of our patients but also the many other needs that they and their families have. This philosophy of patient- and family-focused care - involves systems and services that emphasize healing in a comfortable, relaxed environment.

Quality of Patient Care
Brigham and Women’s Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our inpatient satisfaction survey, sent to patients’ to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the quality of patient care we provide and how we are measured compared with other hospitals.

Brigham and Women’s Hospital Bone and Joint Treatment Team

Year after year, our Orthopaedic Services and Rheumatology are ranked among the top programs in the country by US News & World Report.

The Orthopaedic & Arthritis Center is able to maintain this level of care through a combination of medical expertise, with one of the largest and most experienced staffs in the country; a commitment to quality care, demonstrated by our numerous quality and safety awards; state-of-the-art facilities; and advanced technologies.

Our Orthopaedic & Arthritis Center team of physicians, nurses, physician’s assistants, and staff work closely with colleagues in specialties throughout Brigham and Women’s Hospital and nursing to deliver safe, effective, and compassionate care to every patient.

Find a BWH Orthopaedic Surgeon who specializes in impingement.

Contact Us

If you believe you should have an evaluation and would like to schedule an appointment with one of our orthopaedic experts, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form.