Shoulder pains can be quite a problem.  It may impact your sleep, driving, and brushing your own hair.

One type of shoulder pain includes the pinching of the tendons in the inside part of the shoulder joint; this is referred to as called Shoulder Impingement.

The shoulder joint is complicated.  There is very little space inside the joint and this is what allows the ball and socket joint to work properly. 

What stops the ball from going too far upwards i

n the socket are an elaborate arrangement of little muscles known as the rotator cuff muscles.  They continuously correct their tension to keep the ball in place and when needed, to pull it downwards.


Shoulder Impingement can happen when there's an imbalance of the opposing forces of the downwards pull of the rotator cuff and the upwards pull of the deltoid.

When there's a decrease in the pull in the rotator cuff, the little space which exists over the very top of the shoulder between the ball and socket gets very narrowed.

This may cause swelling and bruising of the rotator cuff tendons, pain, or pressure on the bursa that sits between the very top of the socket along with the tendons.

The very first thing when evaluating patient with shoulder impingement is to do a complete evaluation of  the function of the  shoulder.

This helps to identify if there are

 any imbalances in the muscles supporting the shoulder which could be causing the pain.  In addition, it is important to look at the flexibility of the muscles round the shoulder.  Tight muscles round the rear of the shoulder can lead to impingement and also can drive the ball upwards.

The progression of shoulder impingement  has three stages:

Phase 1 – Reduce Swelling and Pain

Treatment may include ice program and anti-inflammatory drugs  to simply help reduce any swelling or inflammation of the structures in the impingement region.

Phase 2 – Improve Strength

We usually supply some simple home exercises to enhance the strength and flexibility of the muscles in your shoulder to boost your rotator cuff function

Phase 3 – Resumption Of Action

Once the inflammation and the pain has settled and the shoulder function continues to improve, we direct our patients re-introduce some of their activities as tolerated. 

For those who have shoulder pain, this is what we recommend for the short-term:

• Limit any actions overhead

• Prevent yourself lying on the side that is tender

• Use ice packs for 15 minutes intermittently

• Have your shoulder evaluated by your MD or a physical therapist.

To learn more about shoulder pain click HERE