Shoulder Impingement Syndrome

Impingement Syndrome, which is sometimes called Swimmer’s shoulder or Thrower’s shoulder, is caused by the tendons of the rotator cuff (supraspinatus, infraspinatus, teres minor and subscapularis muscles) becoming ‘impinged’ as they pass through a narrow bony space called the subacromial space – so called because it is under the arch of the acromium which is a part of the shoulder blade. With repetitive pinching, the tendon(s) become irritated and inflamed. There are other structures that can cause this so come in for a check to see what the problem is.


  • Shoulder pain that gradually comes on over time
  • Pain at the front/side of the shoulder when lifting the arm above head height
  • Pain at the back and/or front of the shoulder when the arm is held out to the side (abducted) and turned outwards (external rotation)

Article on Impingement Syndromes from ‘Shoulder Solutions’

Rotator Cuff Muscle Strain

These are a group of muscles that help to stabilise the glenohumeral joint (shoulder joint) whilst also rotating it. The muscles that make up the
rotator cuff are; supraspinatus, infraspinatus, teres minor and subscapularis. Supraspinatus and infraspinatus are most commonly injured due to their action of providing a lot of shoulder rotation. With rotator cuff injuries either the muscle/tendon can be damaged or inflammation around these can cause impingement (pinching) of surrounding structures.


  • Acute
  • Pain and tearing feeling giving severe pain
  • Painful raising arm out to the side
  • Very pin point pain
  • Chronic
  • Usually found on dominant side
  • 40+ usually with gradual onset of pain and some weakness
  • Difficult to raise arm in most ranges of movement
  • Can lead to impingement syndromes

Article of rotator cuff injuries from ‘EMedicine’

AC Joint Injury/Separation

The AC joint is where the acromium (part of the shoulder blade) joins the clavicle (collar bone) and is usually the highest part of the shoulder.
Separation of these two bones is due to ligament damage. Most common onset of the pain is falling either onto the shoulder itself or onto an outstretched arm. There are grades from 1-6 for AC separation so you should get it checked out to see how bad the damage is.


  • Pain over the tip of the shoulder; at first the pain is diffuse but later becomes very focal.
  • A ‘step deformity’ may be visible; it is seen as a raised lump on the shoulder
  • Pain when raising the shoulder above shoulder height

Article about AC Joint Separation from ‘AboutOrthopedics’

Shoulder Stiffness

This term describes the tension, tenderness and restrictions felt over the shoulders. Muscular shoulder pain is often related to the position that one holds whilst at work. This can be desk bound or through manual labour. This tightness combines often with stress to give the ‘knots’ people often feel they have in their shoulders. The best treatment for this is massage, stretches and some manipulations to articulate joints beneath.


  • Pain and tenderness into shoulders
  • Restrictions in movement of the neck
  • ‘Knots’ in the muscles surrounding the shoulders

Articles from Shoulder Pain Management