Quick version
What is shoulder impingement?
Impingement occurs when soft tissues in the shoulder joint become pinched during movement. This happens when the space between the upper arm bone and the acromion (the bony roof of the shoulder) is reduced. Most often, it involves tendons from the rotator cuff or the bursa, which acts as a shock absorber in the shoulder.
This pinching can cause pain, irritation, and sometimes inflammation, and it is often aggravated when the arm is lifted above shoulder height. The condition is sometimes referred to as shoulder impingement syndrome and is one of the most common diagnoses in load-related shoulder pain.
Common symptoms of impingement
The most common sign of impingement is pain during movement. Many people describe pain in the shoulder when the arm is lifted out to the side or raised overhead. The pain may also occur during exercise, especially in movements such as bench press, military press, or other pressing exercises.
Some people also experience aching at night, particularly when lying on the affected shoulder. In certain movements, the pain may feel sharp, and it is not uncommon to notice reduced strength in the arm even though it can still be moved.
Why does impingement occur?
Impingement rarely develops from a single cause. It is usually the result of repeated strain combined with reduced control of the shoulder and shoulder blade. Repetitive work, frequent overhead training, or a rapid increase in training load are common contributing factors. Stiffness in the thoracic spine and a forward-rotated posture can also affect the load on the shoulder joint. When the shoulder blade does not move optimally, the risk of tendon and bursa irritation increases.
How impingement differs from other conditions
Shoulder pain can have many different causes, and it is not always obvious what is behind the symptoms. If the pain is mainly triggered by lifting the arm and loading the joint, while shoulder mobility remains normal, this often points toward impingement.
Frozen shoulder usually causes more pronounced stiffness in all movements and develops gradually, whereas a rotator cuff tear often occurs in connection with an injury and is characterized by clear loss of strength. Bursitis may cause more persistent aching even at rest, and pain radiating from the neck down the arm may originate from the cervical spine.
How is shoulder impingement diagnosed?
The diagnosis of shoulder impingement is primarily made through a medical history and a physical examination performed by a doctor or physiotherapist. The assessment is based on which movements are painful, how the symptoms began, and how well mobility and strength function in the shoulder and shoulder blade.
MRI and shoulder impingement
With newly developed symptoms, imaging is rarely needed, but it may be considered in unclear or long-lasting cases. An MRI of the shoulder can visualize soft tissues such as tendons and bursae, and may reveal additional problems such as tears, inflammation, or other structural changes.
Treatment for impingement
The most important treatment for pinched structures in the shoulder is physiotherapy with individualized exercises. Rehabilitation often continues for several weeks and is adjusted according to pain and functional needs. If necessary, pain-relieving or anti-inflammatory medications may be used for short periods. A corticosteroid injection may be considered if the pain is severe enough to prevent exercise, but it should be viewed as a complement rather than a solution on its own. Surgery is rarely the first option and is mainly reserved for long-term cases where rehabilitation has not been effective.
Effective exercises for shoulder impingement
Rehabilitation exercises are essential for recovery. The goal is to strengthen the rotator cuff, improve shoulder blade control, and reduce stress on sensitive structures. The most effective exercises include external rotation with resistance bands, shoulder blade stabilization exercises, and controlled arm raises against a wall, known as wall slides. Eccentric training, where the muscle is used to slow down a movement, increases tendon tolerance. Mobility exercises for the thoracic spine can also help by reducing pressure in the shoulder.
What should you avoid with impingement?
During a more painful phase, certain movements may need to be temporarily limited. Avoid heavy overhead pressing exercises and movements that clearly provoke pain. Complete rest is rarely beneficial—controlled training with light load often supports healing rather than delaying it.
How long does recovery take?
Recovery time varies. Mild cases may improve within four to eight weeks, but for most people a rehabilitation period of around two to three months is required. Long-lasting or recurring problems often require a clear plan and follow-up with a physiotherapist.
When should you seek medical care?
Seek medical attention if you suddenly lose strength in the arm, cannot lift it at all, or if the pain is severe and persistent. You should also seek help if symptoms do not improve after six to eight weeks despite self-care and exercise, or if you suspect a more serious injury.
Related conditions
Other common causes of shoulder pain include rotator cuff injuries, frozen shoulder, and general overuse of the shoulder joint. A correct diagnosis increases the likelihood of effective treatment and reduces the risk of prolonged symptoms.