Subacromial Impingement

Subacromial impingement syndrome (SAIS), or shoulder impingement, is a common cause of shoulder pain. It results from the inflammation and irritation of the tendons on the rotator cuff.

Signs and Symptoms

This includes pain and weakness of the shoulder, resulting in difficulty moving the arms freely (especially when performing overhead and backward motions).

Risk Factors

Those who engage in sports that require excessive and repeated shoulder movements—especially where overhead and forceful motions are involved—are at a higher risk of developing subacromial impingement. Some common examples are swimming, baseball and tennis.

Similarly, those whose professions require heavy lifting and arm movements (e.g. construction) are also at a higher risk. Old age and old shoulder injuries and surgery are also possible risk factors.


The doctor will first assess the shoulder’s range of motion and look for symptoms such as pain, tenderness or swelling. This may be done through special orthopaedic tests where the shoulder will be carefully manoeuvred, and pain felt in certain motions and areas will be taken as a sign of a shoulder impingement.

Where necessary, imaging tests such as an X-ray and Magnetic Resonance Imaging (MRI) will be conducted so that the doctor can see the bones and soft tissues respectively, clearly.


Treatment options for shoulder impingement include:

  • Painkillers and anti-inflammatory medications – Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common medicines prescribed for SAIS. These should be taken only as prescribed.
  • Physiotherapy – Gentle, low-impact exercises for the arms, shoulder and chest can help restore functionality, strength and mobility of these parts.
  • Injections – Corticosteroids reduce pain and inflammation in the affected areas. However, the relief is temporary.
  • Surgery – Shoulder surgery is seldom required, but when necessary, it is typically done through minimally invasive surgery at our clinic. This involves the shoulder surgeon placing injured tendons back to their original position. Traditional open surgery is also an option.

Reduce your chances of developing shoulder impingement (or recurrence) with these tips:

  • Proper training – Ensure your physical exertion is not excessive compared to what you can safely manage. Building up strength and speed over time is key.
  • Equalize the muscles – The muscles in the back around the shoulder blade are often neglected as people tend to focus on building up the muscles in the chest and front of the shoulder. This can result in an unstable shoulder blade.
  • Maintain proper posture Doing so can reduce excess and imbalanced pressure on the shoulder muscles. Avoid slouching as well.
  • Inflammation control. After an intensive exercise session, make sure to take enough rest to keep any swelling at bay. If inflammation occurs, treat it with an ice pack and consult a doctor should pain persist.
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