Dr. Vaishali Suri (P.T.)
What Is Shoulder Impingement?
Shoulder impingement syndrome (SIS) occurs when the soft tissues in the subacromial space — the gap between the acromion (top of shoulder) and the humeral head — are compressed during shoulder elevation. The compressed structures include the supraspinatus tendon, subacromial bursa, and long head of biceps tendon. Impingement is the most common cause of shoulder pain, accounting for 44–65% of all shoulder pain presentations.
Types of Impingement
Primary Structural Impingement: Caused by bony abnormalities — a hooked or curved acromion that narrows the subacromial space. Secondary Functional Impingement: The most common type — caused by muscle imbalance and poor movement mechanics that narrow the functional subacromial space during movement. This type responds well to physiotherapy.
Causes of Functional Impingement
Weak rotator cuff muscles (particularly infraspinatus and subscapularis) fail to adequately depress and centralise the humeral head during shoulder elevation, causing superior humeral head migration. Weak and poorly coordinated scapular muscles fail to adequately rotate the scapula during arm elevation, further narrowing the subacromial space. Forward head and rounded shoulder posture changes the resting scapular position unfavourably.
Physiotherapy Treatment
Rotator Cuff Strengthening
Progressive strengthening of all rotator cuff muscles, with emphasis on the posterior cuff (infraspinatus, teres minor) and the depression function of the subscapularis. Research shows this is the most important intervention for secondary impingement.
Scapular Stabilisation
Lower trapezius, serratus anterior, and middle trapezius strengthening restores normal scapular kinematics (upward rotation during arm elevation). This is often more important than rotator cuff strengthening alone.
Postural Correction
Addressing thoracic kyphosis and forward shoulder posture through mobility work and postural strengthening improves the baseline mechanics of the shoulder complex.
Shoulder Impingement Treatment in Faridabad
At Realign Rehab Clinic, NIT-5, Faridabad, we resolve shoulder impingement with targeted physiotherapy. Book your shoulder assessment today.