Chiropractic & Physiotherapy

Rotator Cuff Impingement

Rotator Cuff Impingement is a type of injury that causes shoulder pain where a tendon inside your shoulder rubs or catches on nearby tissue and bone as you forward flex or abduct your arm. It usually affects the rotator cuff tendon that connects the rotator cuff muscles that stabilizes the shoulder joint to the humerus.

The estimated prevalence of shoulder complaints is 7–34% with about 14.7 new cases per 1000 patients per year seen in clinics. Of all the shoulder disorders, shoulder impingement syndrome (SIS) is the most commonly reported, accounting for 44–65% of all shoulder pain complaints.

Who gets Rotator Cuff impingement?

Rotator Cuff impingement syndrome is commonly seen in people who are involved in activities and sports with frequent overhead motion like swimming, badminton, squash, basketball and volleyball. The constant rubbing of the rotator cuff between the humerus and top outer edge of the shoulder leads to swelling and further narrowing of the space which leads to pain. Besides that, RC impingement can also result from an injury, such as falls and motor vehicle accidents.


There were two clinical test can be performed to assess Rotator Cuff Impingement

The first is called the “Empty Can test”. The patient stands up with his shoulders in 90°abduction, 30° horizontal adduction and in complete end range rotation. The therapist fixates his hands on the upper arm of the patient and provides a downward pressure while the patient tries to maintain his position.

The second test is called the “Hawkin’s Test”, the patient stands with the shoulders abducted to 90° and internally rotates the forearm. The presence of pain with movement is an indicator of a possible pathology.

Physiotherapy Management

The aim of physiotherapy management is to reduce pain and swelling of the tendons to achieve normal range of motion and improve the strength of the shoulder. Rest and ice should be implemented at the acute phase of injury to decrease pain and inflammation. It is very important that patients need to avoid activities that increases pain and symptoms. Physiotherapist should guide the patient on when to resume those activities again based on the recovery rate on each individuals.

Physiotherapist can use techniques like muscle release to improve range of motion and prepare patient for strengthening exercises when the pain and inflammation reduces. It is important for patient to do exercises in a correct order; starting with stretching and range of motion exercises and then muscle strengthening exercises.

It has been shown that exercises are effective and support the improvement of shoulder impingement compared to no treatment or placebo.

The following suggestions are to include in the rehabilitation of shoulder impingement:

  1. Gentle Muscle Release
  2. Isometric Exercises to reduce pain
  3. Stretching and range of motion exercises
  4. Kinetic Chain Exercises
  5. Correcting Technique and training errors
  6. Correcting scapula-humeral rhythm and glenohumeral instability
  7. Resistance training to increase mobility

Here in Healthworks, our physiotherapist will perform a thorough assessment regarding your injuries and design a general guidelines and precautions. If there are any queries regarding this article, feel free to contact us at 018-9828539/ 03-6211 7533 or drop us an email at