Shoulder Impingement Syndrome – Paul Dardagan

Over the last few months I have been attending a few gyms around the Pyrmont area which include the Ian Thorpe Centre and University of Sydney of Technology to conduct some screening sessions for a number of members associated with the gyms. There has been a variety of conditions I have come across but one in particular has been prominent. Shoulder Impingement has been undoubtedly the most common complaint. I have recognised this condition is poorly understood and commonly mistreated. So far, I found that clients tend to try treat themselves by using Dr Google or following poor advice from non-professionals. So lets look a little closer to what shoulder impingement means and how important it is to seek professional advice and management.

shoulder-anatomy11            SHoulder Impingement Syndrome


Shoulder Impingement

Shoulder Impingement is a common condition that is caused when the rotator cuffs are pinched as they pass through the subacromial space formed between the Coraco-Acromial arch, AC joint, Acromion and the Glenohumeral joint. This impingement can cause swelling and damage to the muscle and tendons.  Shoulder Impingement can be:

  • External
  • Primary
  • Secondary
  • Internal

Primary External Impingement:

  • Abnormal surrounding bony structures –> A curved or hooked acromion
  • These abnormalities can be congenital or a build up of bony growth (osteophytes)
  • Thickening of the Coraco-Acromial arch
  • Bony formation of the AC joint

Secondary External Impingement

  • Inadequate scapula stabilisation –> the rotating scapula pinches down on the subacromial space –> this is a results of weaker or tighter stabilizing muscles creating an imbalance

Internal impingement

  • This commonly occurs in the late stage of throwing whereby the rotator cuff tendons are impinged between the humeral head and the glenoid (scapula).

 Treatment options &  How to Treat Shoulder Impingement

Treatment is completely dependent on the type of impingement that has caused your pathology and will always begin with a conservative approach including:

  • An accurate diagnosis of the cause of impingement which will be given to you by your Physiotherapist
  • Rest
  • Soft tissue techniques
  • Dry needling
  • Rotator cuff and periscapular strengthening
  • Self-reliant strategies using rollers, trigger point balls

Generally speaking a successful conservative treatment should take between 3-6 weeks.

Non conservative approach –> only explored with an unsuccessful conservative approach

  • Cortisone Injection
  • Surgical intervention –> looking at repairing any torn tissue or address any primary external impingement structures

It is important to understand that both these interventions will require between 4-6 months of Physiotherapy rehabilitation and are by no means a quick fix.


 Useful products for optimal self Management sold at at bounceREHAB:

TENS portable devices $200


Anti-Flamme topical cream $25 & $ $45 (90 & 450 grams)


Heat packs $35


Cold Compression Cryo Cuff Hire $30 per week (plus deposit)


Pilates Home Kits (exercise tubing) $30 or Theraband $10/meter


Shoulder Door Pulleys $20


Foam Rollers – small $35 large $55

Foam Roller

T-rack $135


As our online store is currently under constructions please contact or (02) 9571 7606 for orders


Paul Dardagan
PHYSIOTHERAPIST M.Physiotherapy, PG Cert. Human Movement Sc, B. Coaching Sc