Shoulder Impingement - Dr. Burke Orthopedics

Shoulder Impingement – Relieving Pain and Restoring Smooth Movement

Overview

Shoulder impingement occurs when the tendons of the rotator cuff become compressed or irritated as they pass through the narrow space between the bones of the shoulder joint — particularly under the acromion, a bony structure on top of the shoulder blade.

This compression leads to inflammation, pain, and restricted movement, especially during overhead activities like reaching, lifting, or throwing. Over time, untreated impingement can progress to rotator cuff tendinitis or tears, making early diagnosis and treatment crucial.

At Dr. Burke Orthopedics, patients from Pearland, Houston, Friendswood, and Southeast Texas receive comprehensive care for shoulder impingement, combining advanced diagnostics, therapeutic rehabilitation, and minimally invasive treatment options to restore function and relieve pain.

Understanding Shoulder Impingement

The shoulder joint is designed for wide, fluid movement. However, when the space between the acromion (top of the shoulder blade) and the humeral head (upper arm bone) becomes too narrow, the rotator cuff tendons can rub or “impinge” during arm movement.

This repetitive friction causes inflammation and irritation of the tendons and bursa (a fluid-filled sac that cushions the joint), resulting in pain that worsens with activity or reaching overhead.

Common Causes and Risk Factors

Shoulder impingement can result from a combination of mechanical, structural, and lifestyle factors.

Common causes include:

Repetitive overhead motion: Common in athletes (swimmers, baseball players) and certain occupations (painters, mechanics).
Poor posture: Rounded shoulders or slouched posture compress the shoulder joint space.
Muscle imbalance or weakness: Causes abnormal shoulder mechanics.
Muscle imbalance or weakness: Causes abnormal shoulder mechanics.
Bone spurs: Bony overgrowth on the acromion reduces space for the tendons.
Inflamed bursa (bursitis): Contributes to additional crowding within the joint.

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Risk Factors:

Age over 40
Overhead or repetitive activities
Shoulder instability or previous dislocation
Arthritis or bone changes
Weak rotator cuff or upper back muscles

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Symptoms

Symptoms of shoulder impingement may start gradually and worsen over time with continued use of the arm.

Common symptoms include:

Sharp or aching pain when lifting the arm overhead
Discomfort reaching behind the back or head
Weakness or stiffness in the shoulder
Pain that worsens at night, especially when lying on the affected side
Clicking or popping sensations during movement
Decreased range of motion

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Pain often increases during repetitive activities, such as throwing, swimming, or working overhead.

Diagnosis

At Dr. Burke Orthopedics, Dr. Robert L. Burke, a board-certified orthopedic surgeon, performs a thorough evaluation to identify the cause and severity of impingement and determine whether tendon or bursa damage has occurred.

Diagnostic process includes:

Medical history: Evaluating activity type, duration of symptoms, and prior shoulder injuries.
Physical examination: Special tests (Neer’s and Hawkins-Kennedy) help reproduce symptoms and confirm impingement.

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Imaging:

o X-rays: Detect bone spurs, acromion shape, or arthritis.
Ultrasound: Evaluates soft tissue inflammation in real time.
MRI: Reveals rotator cuff tendon irritation, tears, or bursal inflammation.

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A precise diagnosis allows for an individualized treatment plan to restore movement and reduce inflammation.

Treatment Options at Dr. Burke Orthopedics

Dr. Burke focuses on relieving pain, improving joint mechanics, and preventing tendon damage through a combination of conservative and advanced treatment methods.

Non-Surgical Treatments

Rest and activity modification: Avoiding repetitive overhead motion or heavy lifting.
Anti-inflammatory medication: Reduces swelling and pain in the tendons and bursa.
Cold and heat therapy: Helps decrease inflammation and improve blood flow.
Corticosteroid injections: Provide short-term pain relief in severe inflammation cases.

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Physical Therapy

Improves posture and shoulder alignment.
Strengthens rotator cuff and scapular stabilizing muscles.
Restores normal shoulder motion and prevents future impingement.

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PRP Therapy

Platelet-rich plasma injections promote tendon healing and reduce inflammation naturally.

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Surgical Treatments

If pain persists after several months of conservative therapy, surgical treatment may be necessary.
Dr. Burke offers advanced, minimally invasive procedures to restore normal space within the shoulder joint:

A small incision is made to release part of the fascia, relieving tension and inflammation.
Can be performed endoscopically for quicker recovery.

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Arthroscopic Subacromial Decompression

Removes bone spurs or reshapes the acromion to relieve pressure on tendons.
Cleans inflamed bursa tissue to improve smooth motion.

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Rotator Cuff Repair:

Addresses coexisting tendon tears that often accompany chronic impingement.

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Reconstructive Surgery

Recommended in complex cases with structural abnormalities or recurring impingement.

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These techniques minimize recovery time and preserve natural shoulder function.

Recovery and Rehabilitation

Typical recovery timelines:

Non-surgical: 4–6 weeks for significant pain relief and restored range of motion.
Arthroscopic decompression: 3–6 months for full recovery and strength rebuilding.

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Rehabilitation goals:

Control pain and inflammation
Regain flexibility and mobility
Strengthen rotator cuff and upper back muscles
Improve posture and shoulder mechanics

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Ongoing home exercises and guided physical therapy ensure durable, long-term results.

Long-Term Outlook and Prevention

Shoulder impingement usually responds well to early treatment and consistent rehabilitation.
Most patients regain full function and prevent recurrence through lifestyle and posture adjustments.

Prevention tips:

Warm up and stretch before physical activity
Strengthen shoulder stabilizers and rotator cuff muscles
Avoid repetitive overhead lifting without breaks
Maintain proper posture during work and daily activities
Seek care early if shoulder discomfort persists

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Preventive conditioning helps maintain strong, balanced shoulder mechanics for years to come.

When to Seek Medical Care

You should schedule an orthopedic consultation if:

Shoulder pain persists for more than two weeks
Lifting or reaching overhead is painful or weak
You experience clicking, stiffness, or night pain
You’ve tried home care but symptoms persist

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Early evaluation prevents progression to tendon damage or chronic inflammation.

Take the First Step Toward Recovery

If shoulder pain is affecting your movement or daily activities, professional orthopedic care can help restore your strength and comfort.

At Dr. Burke Orthopedics, we specialize in diagnosing and treating shoulder impingement with precision and care — from conservative therapy to minimally invasive arthroscopic treatment.

We proudly serve Pearland, Houston, Friendswood, and Southeast Texas, offering personalized treatment plans and compassionate support every step of the way.

Call (713) 436-3488 or Request an Appointment Online to schedule your consultation with Dr. Robert L. Burke, board-certified orthopedic surgeon specializing in shoulder and upper extremity conditions.

Medical Disclaimer:

The information provided on this page is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified healthcare provider with any questions you may have regarding medical condition or treatment. Do not disregard professional medical advice or delay seeking it because of information you have read here. If you are experiencing severe pain, numbness, or loss of function, please contact a medical professional immediately or visit your nearest emergency center.