Subacromial Impingement Syndrome refers to the inflammation of the rotator cuff tendons during attempts to lift the arm above shoulder level. It is also known as subacromial impingement, swimmer’s shoulder, or thrower’s shoulder, and it primarily results from repetitive overuse of the shoulder in daily activities.Causes of Subacromial Impingement Syndrome
Subacromial impingement is essentially an overuse syndrome. Repetitive movements inherent to certain occupations or sports—such as swimming, volleyball, tennis, baseball, construction work, and electrical work—that involve elevation and rotation of the arm above shoulder level, place significant stress on the shoulder joint, leading to the development of the syndrome.In addition to overuse, subacromial impingement syndrome may also result from:
- Excessive fatigue
- Poor technique
- Intense exercise, especially when muscles are unconditioned
- Previous shoulder injuries
- Genetic predisposition
- Osteoarthritis
- Scoliosis
- Kyphosis
- Muscular imbalances
- Calcific tendinitis
- Rotator cuff tendinopathies
- Rotator cuff or labral tears
- Joint instability
- Poor posture
Other contributing factors
Symptoms of Subacromial Impingement Syndrome
Subacromial Impingement Syndrome presents with a largely consistent set of symptoms among affected individuals. These symptoms include:
- Shoulder pain, which may range from mild to severe and constant. Pain often worsens at night and can awaken the patient, particularly when sleeping on the affected shoulder.
- Weakness or fatigue of the upper limb
- Sensation of shoulder instability
- Limited range of motion of the shoulder
- Difficulty performing daily activities
Diagnosis and Management of Subacromial Impingement Syndrome
Accurate diagnosis requires a thorough clinical examination, during which the clinician may employ various diagnostic tests, such as the Neer test and Hawkins test. If necessary, additional imaging studies—including radiographs, ultrasound, or magnetic resonance imaging (MRI)—may be requested.Following diagnosis, the physician will recommend the most appropriate treatment strategy, which may include conservative or, in selected cases, surgical interventions.
Subacromial Impingement Syndrome can be managed through:
- Rest and avoidance of activities that aggravate the symptoms
- Pharmacological therapy with anti-inflammatory medications
- Cryotherapy
- Physiotherapy
- Strengthening exercises
- Improvement of technique in sports or occupational activities
- Posture correction
- Platelet-rich plasma (PRP) injections
- Surgical intervention, if conservative treatments fail or if there is labral damage. Arthroscopic surgery is typically employed, offering excellent outcomes with minimal incisions, reduced postoperative pain, and faster patient recovery
Proper technique, adequate warm-up and cool-down routines, muscle strengthening, and awareness of the body’s limits are essential factors that can prevent the development of subacromial impingement and its associated painful symptoms.
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