Shoulder Impingement: Causes, Symptoms, and Prevention

Shoulder Impingement: Causes, Symptoms, and Prevention

Shoulder impingement is a common cause of shoulder pain that can affect your daily activities and overall mobility. If you’ve experienced discomfort in your shoulder that you think may be shoulder impingement or heard others mention it and wondered what it was, then this guide will help you understand what it is, why it happens, and how to prevent it.

What Is Shoulder Impingement?

Shoulder impingement occurs when the structures in the subacromial space—located above the ball-and-socket joint of the shoulder—become “pinched” or compressed. This space is incredibly small, with a normal range of 7-14mm when the arm is at rest (for comparison, a pea is 10mm).

"Slagter - Drawing Impingement of shoulder - no labels" by Ron Slagter, license: CC BY-NC-SA (note: image has been cropped and labeled for this use)

Key components within this space include:

  • Supraspinatus Tendon: Part of the rotator cuff.
  • Long Head of the Biceps Tendon: Passes through a groove before joining the subacromial space.
  • Subacromial Bursa: A fluid-filled sac that prevents friction between tendons and bones.

When these structures become inflamed due to overuse or strain, the space narrows further, increasing the likelihood of impingement, particularly during repetitive overhead movements.

Symptoms of Shoulder Impingement

Symptoms include generalized shoulder pain that may radiate down the arm, discomfort during midrange arm movements (known as a “painful arc”), and pain at night, especially when sleeping on the affected shoulder. You might also notice decreased strength or difficulty lifting your arm overhead. If these symptoms persist, consult a healthcare professional for an evaluation and appropriate treatment.

What Causes Shoulder Impingement?

Shoulder impingement is often caused by repetitive strain or improper movement patterns. Key contributors include:

  • Frequent Overhead Activities: Prolonged or repetitive overhead movements narrow the subacromial space and fatigue the stabilizing rotator cuff muscles.
  • Overuse of the Biceps: Repeated overreaching or improper throwing mechanics can strain the biceps tendon, leading to inflammation.
  • Suboptimal Shoulder Positions: Poor positioning—such as the “chicken wing” posture (elbows flared above shoulder height)—increases stress on the rotator cuff.

Preventing Shoulder Impingement

To protect your shoulders and minimize injury risk:

  • Limit time spent overhead, get into better positions if possible, or take breaks and interrupt exercises to refresh the shoulder.
  • Anchor the shoulders to support the shoulder complex and allow larger muscle groups to take on the majority of the work.
  • Push or pull directly in line with your shoulder instead of reaching across your body.
  • Avoid the “chicken wing” posture by using a palm-up or palm-in grip to maintain proper alignment.
  • Keep your arms within a 20° range forward from the side of the body, and slightly below full overhead extension when applying forces.

Rehabilitation and Recovery

If you suspect shoulder impingement, focus on reducing irritation and strengthening the stabilizing muscles around the shoulder and shoulder blades. Proper rehabilitation includes exercises targeting mobility and stability, guided by a healthcare professional.

Conclusion

Shoulder impingement can significantly impact your quality of life, but with awareness and preventive measures, you can protect your shoulder health. Download our free MoveSafe Mindset, link below, to share the helpful tips you have learned with your colleagues, friends or family.

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