Shoulder Impingement Syndrome Treatment in Guelph & Wellington County
Shoulder impingement syndrome occurs when tissues in the shoulder become pinched or irritated during certain movements, often when reaching overhead, behind your back, or across your body. Our physiotherapists pinpoint what’s causing the impingement and design treatment to reduce your pain and restore your shoulder’s function.
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Shoulder impingement syndrome describes what happens when structures within the shoulder joint, most often the subacromial bursa and/or rotator cuff tendons, become intermittently jammed or compressed during movement. The ball-and-socket joint of the shoulder sits beneath the acromioclavicular (AC) joint, and the space between the two, called the subacromial space, is where this impingement occurs.
With normal shoulder function, the subacromial space stays large enough throughout movement to avoid impingement, but for some people this isn’t the case. Pain is most often felt when reaching overhead, behind the back, or across the body – for example, reaching into a cupboard, pulling on a pair of pants, tucking in a shirt, or reaching for a seatbelt. Pain can also radiate down toward the elbow, disrupt sleep on that side, or show up as weakness with lifting, pushing, or pulling. Left unaddressed over time, mechanical issues like this can lead to other conditions such as bursitis or tendonitis of the rotator cuff.
Common causes of Shoulder Impingement Syndrome
Shoulder impingement can be divided into two main categories:
- Primary (structural) impingement from a naturally narrower subacromial space, such as a decreased angle of the AC joint
- Primary (structural) impingement from bony spurs that develop in the subacromial space with osteoarthritis
- Secondary (dynamic) impingement from poor posture or joint hypermobility/instability
- Secondary (dynamic) impingement from muscular weakness following trauma, which affects control of the shoulder blade and joint
How we treat Shoulder Impingement Syndrome
At your first appointment, your physiotherapist will run through a series of observations and tests to help identify the cause of your impingement. In some cases, your therapist or family doctor may also recommend an ultrasound, which can help identify impingement as well as related conditions like bursitis, tendonitis, or rotator cuff tears. Based on your findings and goals, your treatment program may include:
- Ultrasound and TENS for pain control
- Taping of the shoulder joint
- Manual therapy techniques to improve range of motion
- A progressive home exercise program tailored to your specific findings
Recovery Timeline
Most cases of shoulder impingement improve steadily with physiotherapy, and your physiotherapist will outline a realistic timeline based on your specific findings at your first assessment. Your commitment is typically 2–3 visits a week for 20–30 minutes, along with progressive in-clinic and home exercises.
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Frequently Asked Questions
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Common questions about shoulder impingement and physiotherapy. Still have questions? We’re happy to help.
No. Physiotherapists in Ontario are primary care providers, so you can book an assessment directly. Direct billing to most major insurers is also available at our clinics.
Pain is most often felt when reaching overhead, behind your back, or across your body – think reaching into a cupboard, pulling on a pair of pants, or reaching for a seatbelt. Pain can also radiate down toward the elbow or disrupt sleep on that side.
Structural (primary) impingement comes from the natural shape of your joint, such as a narrower subacromial space or bony spurs. Dynamic (secondary) impingement usually results from posture, joint instability, or muscular weakness that keeps the joint from moving the way it should. Your assessment identifies which pattern applies to you.
It can. Left unaddressed, the mechanical issues behind impingement can progress into other conditions, such as bursitis or tendonitis of the rotator cuff. Starting treatment early helps prevent that progression.
Not always. Your physiotherapist can usually identify impingement through a hands-on assessment. An ultrasound is sometimes recommended by your therapist or doctor, and can also help rule out related conditions like bursitis, tendonitis, or a rotator cuff tear.
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