Hi, I’m Matthew Barrett, an orthopaedic shoulder and elbow surgeon with private clinics in Dorset, and today I want to talk about something I see quite often in my clinic: shoulder impingement. You may have heard it called Rotator Cuff Related Pain or Subacromial Pain, but what does that actually mean? And more importantly, how can you find relief?
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So, What Exactly Is Shoulder Impingement?
Impingement syndromes are one of the most common clinical diagnoses for shoulder pain. Shoulder impingement is when the tendons in your shoulder, particularly the supraspinatus tendon, become irritated or inflamed. This area, called the subacromial space, is pretty tight and when the tendons swell, it can cause pain and restrict your movement. It’s often triggered by something as minor as reaching for something awkwardly or simply overdoing it at the gym. It starts with inflammation of a small fluid-filled sac called the bursa, which acts like a cushion, but if the inflammation persists, the tendons themselves can become involved.
You might notice pain when lifting your arm, weakness, or even trouble sleeping on the affected side. Sound familiar?
What Causes It?
There’s no single cause of shoulder impingement—it can happen to anyone. But some common reasons include:
Overuse: Repetitive overhead activities, like swimming or painting, put strain on the shoulder.
Minor injuries: Sometimes a small injury is all it takes to kickstart the inflammation.
Ageing: As we get older, our tendons can weaken, making us more prone to problems.
The good news? It’s manageable, and most people don’t need surgery to get better.
How Do We Treat It?
Step 1: Rest and Activity Modification
The first thing you need to do is rest and modify your activities. This doesn’t mean you have to stop moving altogether, but it does mean avoiding activities that aggravate your shoulder—things like lifting or repetitive overhead movements. Giving your shoulder a break can help ease the inflammation.
Step 2: Anti-inflammatory Medication
Next, anti-inflammatory medications (like ibuprofen) can help reduce the swelling and ease the pain. These can be really effective in the early stages, but always check with your GP if you’re unsure whether these are safe for you.
Step 3: Physiotherapy—The Key to Recovery
Now, this is where the real work begins. Physiotherapy is the mainstay of treatment for shoulder impingement. A physio will guide you through exercises that help strengthen the muscles around the shoulder, improve mobility, and get your tendons moving smoothly again.
There are three specific exercises I often recommend, and you can find detailed instructions on them here. They’re simple but really effective for getting your shoulder back on track.
Step 4: Steroid Injections
If the pain is severe and stopping you from making progress with physio, we might consider a steroid injection. This can provide temporary relief by reducing inflammation, allowing you to engage more fully in your exercises.
Step 5: Surgery (But Only as a Last Resort)
Surgery is usually not necessary for shoulder impingement. In rare cases, where conservative treatments haven’t worked and the pain is significantly affecting your life, surgery can help by clearing space in the shoulder so the tendons aren’t pinched. But for most people, a good physio program and some patience will do the trick.
Why Early Treatment Matters
The sooner you address shoulder impingement, the better your chances of avoiding long-term problems. Left untreated, this condition can worsen over time and even lead to a rotator cuff tear, which is more serious and harder to treat.
If you’ve been struggling with shoulder pain, don’t ignore it. Get ahead of it with early treatment, including rest, physio, and possibly an injection. You may be surprised to learn that people find significant relief without the need for surgery!
Book An Initial Appointment
I’m here to help you get back to doing the things you love, without the shoulder pain. Whether it’s advice, treatment, or just reassurance, feel free to reach out. We can develop a plan to get your shoulder feeling strong again. Book an initial appointment with me at one of my private clinics in Dorset.
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