Dee Why Chiropractor Treatments

Shoulder impingement

Shoulder impingement is one of the most common shoulder complaints. There is limited space the shoulder has to move within when performing an overhead movement. If the shoulder isn’t supported well structures within this space (subacromial space) can get ‘pinched’. If they continue to repeatedly become pinched the following conditions can occur:

  • Tendinitis and tendinopathy – tendons are irritated and breakdown
  • Bursitis – fluid sack designed for lubrication becomes inflamed.

It is a very good time to deliver some home truths about impingement. This seems to be the ‘basket’ that everyone with a painful arc (pain on arm raising) or anterior (front) shoulder pain gets thrown into. Shoulder impingement is a classic misdiagnosis. Not everyone with shoulder pain on arm elevation has impingement. Not all ‘impingements’ are due to a weak rotator cuff. Furthermore, impingement is a reality with anyone and everyone, we all get impingement (to a degree) and for most its not a problem. Said a little differently, every single person can impinge their shoulders with enough arm elevation. Its a normal physiological/anatomical component of end range shoulder movement. I’m going to say that again, why? Because its very important. Every single person can impinge their shoulder with enough arm elevation and this is completely normal. This is why we do not like the term ‘impingement’ as a diagnosis or classification at Sydney Spine & Sports Centre. Regardless of the term ‘impingement’ any shoulder pain should be evaluated by someone who knows the shoulder very well. Ie they specialise in it. An exact treatment strategy based on repeated testing and mechanical diagnosis should be the starting point. Our chiropractors and physiotherapists will spend a lot of time testing the shoulder to get the diagnosis and treatment strategy right!

Causes of shoulder impingement

Anyone can technically ‘impinge’ or ‘pinch’ their shoulder if they raise and internally rotate the shoulder above the head enough. Therefore any of us could be at risk of this condition if we repeatedly do overhead activities such as playing tennis. However this all depends on what we do (or don’t do), how often we do it, and how well we do it. Some people are more prone and common causes of impingement syndrome can be categorised by the following:

  • Anatomical variation in the shape of the acromion (type II or III)
  • Overuse or repetitive stress
  • Poor rotator cuff strength
  • Poor shoulder biomechanics
  • Shoulder instability

Symptoms of shoulder impingement

Shoulder pain is the most common symptom shoulder impingement syndrome (SIS). This usually comes from a combination of irritation to the bursa and rotator cuff tendons, not one or the other. The following symptoms are common, as recorded by our chiropractors and physiotherapists:

  • Pain during rest and during activity
  • Shoulder pain at night
  • Loss of strength and weakness
  • Difficulty elevating the shoulder
  • Difficulty doing up a bra (internal rotation)


Sydney Spine & Sports Centre (S3C) is a shoulder pain treatment centre of excellence. Non-surgical treatments of the shoulder are preferred for shoulder impingement syndrome in the initial stages. If continued, associated damage to tendons and bursae develop with progressive and worsening impingement then one of our chiropractors or physiotherapists may need to send you for a surgical opinion or for an injection. Our chiropractors and physiotherapists in Balmain and Dee Why take an evidence-based approach to the treatment of shoulder impingement syndrome. There is a large clinical focus on pain reduction and functional restoration through both hands on chiropractic and physiotherapy treatments and exercises to improve mobility (joint mechanics/range) and muscle qualities such as control, endurance, strength and power.

Please read these articles on common shoulder problems for greater understanding