Shoulder Impingement
Pinching pain in the shoulder when reaching overhead, often from rotator cuff or scapular dysfunction.
Shoulder impingement — now more accurately described as subacromial pain syndrome — occurs when the rotator cuff tendons and subacromial bursa are repeatedly compressed beneath the acromion during overhead motion. It accounts for 44–65% of all shoulder pain complaints in primary care (van der Windt, Ann Rheum Dis). Contemporary research has moved away from a purely 'structural pinching' model toward a multifactorial picture involving rotator cuff tendinopathy, scapular dyskinesis, and thoracic spine stiffness.
Patients typically report a painful arc between 60° and 120° of shoulder abduction, pain reaching overhead or behind the back (combing hair, fastening a bra, reaching into the back seat), difficulty sleeping on the affected side, and a sense of weakness or catching when lifting. Pain may radiate down the outside of the upper arm but rarely past the elbow.
Most common in adults over 40, but also frequent in overhead athletes — swimmers, baseball/softball players, volleyball players, CrossFit athletes, and tennis players. Manual laborers (painters, electricians, drywallers) and desk workers with forward-rounded posture are also high-risk groups.
A combined, root-cause approach.
Multiple high-quality RCTs (Haik et al., BJSM 2016) show that combined manual therapy and progressive rotator cuff/scapular exercise produces outcomes equal to or better than subacromial injection or surgery for non-traumatic impingement. We mobilize the stiff thoracic spine and glenohumeral joint, release the pec minor, lats, and posterior cuff with ART and dry needling, and progressively load the rotator cuff and scapular stabilizers to restore clean overhead mechanics.
- Adjustments to the thoracic spine and shoulder
- ART for rotator cuff and pec minor
- Dry needling
- Scapular and rotator cuff rehab
Related Conditions
View all →Carpal Tunnel Syndrome
Numbness, tingling, or weakness in the hand from median nerve irritation — often higher up the arm than you think.
Rotator Cuff Injury
Strain, tendinopathy, or partial tears of the rotator cuff causing pain and weakness.
Tennis & Golfer's Elbow
Tendinopathy on the outside (tennis) or inside (golfer's) of the elbow from overuse.