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Shoulder Impingement Syndrome

Shoulder impingement syndrome (SIS) is a common cause of shoulder pain in adults. People with the condition experience pain related to the shoulder's tendons and soft tissues when lifting the arm overhead.

The extension of bone at the top outer edge of the scapula (shoulder blade) is called the acromion. When someone lifts their arm overhead, the space between the acromion and humeral head (top of the upper arm bone) gets smaller. In this space are the rotator cuff, biceps tendon and bursa (sac of cushioning fluid). Compression (impingement) of these structures causes pain and limits movement.

Inflammation of the bursa (bursitis) or of the tendons of the rotator cuff or biceps (tendinitis) is painful. Over time, degenerative changes can occur in the tendons (tendinosis). In some circumstances, repeated rotator cuff impingement can cause partial tears in the tendons. These may even lead to larger or complete tears over time.

Repetitive arm movements, particularly those performed overhead during certain sports – such as swimming, volleyball or tennis – can increase the likelihood of developing SIS. This pain may also develop as a result of a minor event in which there is impact, such as a fall onto the shoulder or outstretched hand. In some cases, the problem has no obvious cause.

Our Approach to Shoulder Impingement Syndrome

Many patients with SIS get better with rest and physical therapy. Pain medications can also be useful, and in some cases, cortisone injections into the shoulder joint can reduce pain and swelling, aiding recovery.

If the pain persists and specific structures require attention, surgery is an option. For these patients, our team includes orthopedic surgeons who specialize in the shoulder and physical therapists who focus on working with orthopedic and sports medicine patients. These experts work together to relieve pain and restore mobility, so patients can return to their normal lives and favorite activities.

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UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.