It is important to get proper treatment for shoulder impingement syndrome as soon as it occurs. If left untreated, secondary conditions can result from it, including:

• Irritation of the bursa.
• Rotator-cuff tendinitis or tears.

Physiotherapy can successfully treat shoulder impingement syndrome. Your physiotherapist will work with you to devise a treatment plan that is specific to your condition and goals. Your personalized treatment program may include:

• Patient education. Your Physiotherapist will educate you about your condition. They will work with you to identify any external factors causing your pain. They may recommend changes to the type and amount of exercises you perform, your athletic activities, and your home or work activities. They will develop a personalized exercise program to help ensure a pain-free return to your desired activities.
• Pain management. Your physiotherapist will design a program to address your pain that includes applying ice to the affected area. They also may recommend changing some activities that cause pain. Physiotherapists are experts in prescribing pain-management techniques that reduce or eliminate the need for medicines, including opioids.
• Range-of-motion exercise. The mobility of the shoulder joint and scapula can be limited. This causes increased stress to various structures. Your condition may be forcing the shoulder to work at a disadvantage. Your Physiotherapist may teach you self-stretching techniques to decrease tension and help restore normal motion of the shoulder region and arm function.
• Manual therapy. Your Physiotherapist may treat your condition using “hands-on” treatments (manual therapy) to gently move your muscles and joints. These techniques help improve motion. They also may be used to guide the region into a less stressful movement pattern.
• Muscle strengthening. Muscle weaknesses or imbalances can contribute to impingement of the shoulder joint as the scapula deviates due to weakness. Based on the level of your injury, your physical therapist will design a safe, personalized, progressive resistance program for you. It may include your core (midsection). You may begin by performing strengthening exercises lying on a treatment table or at home on the bed or floor. You then may advance to exercises in a standing position. Your physiotherapist will choose what exercises are right for you, based on your age and physical condition. Your plan may include using resistance machines at the clinic. Your physiotherapist also will determine if going to a gym is appropriate.
• Functional training. Once your pain, strength, and motion improve, you will need to safely transition back into more demanding activities. To minimize the stress to the shoulder joint, it is important to teach your body safe, controlled movements. Based on your movement assessment and goals, your Physiotherapist will create a series of activities to help you learn how to use and move your body correctly and safely. These may include retraining of activities such as throwing, swinging a racket, or a work activity.