The shoulder is made up of the humerus (upper arm bone), the scapula (shoulder blade), and the clavicle (collarbone). The location above the head of the humerus is known as the subacromial space (below the acromion of the scapula). This space is normally a very narrow space that houses the tendons of the rotator cuff and the subacromial bursa (a fluid filled sac for lubrication). When the shoulder is elevated (flexed up to raise the arm) or internally rotated this space becomes narrower, causing an impingement.

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What are the signs and symptoms of Shoulder Impingement Syndrome?

  • Shoulder pain with raising the arm
  • Worsening pain with increased activity
  • Soreness or aching following activity or at night
  • Decreased range of motion due to pain

Who is More Likely to Develop this Condition?

Shoulder impingement syndrome most often affects children and teens who participate in sports requiring repeated overhead arm movements. Baseball, softball, swimming, volleyball and tennis are common examples. Repetitive motion can place stress on the shoulder over time, leading to irritation and pain.

What Causes Shoulder Impingement Syndrome?

  • Strong internal rotator muscles and weakness of the periscapular muscles (muscles around the scapula)
  • Overuse without proper rest
  • Drastic changes in training routine
  • Unequal shoulder flexibility compared to the other side

How is Shoulder Impingement Syndrome Treated?

At first, most doctors will recommend taking a break from activities that aggravate the shoulder. Then:

  • After the pain subsides, physical therapy might be the next step. This will help to regain motion and strength.
    • Physical therapy focuses on the periscapular muscles and stretching of the internal rotator and pectoralis muscles. This approach helps restore normal motion to the humerus within the glenoid (the socket of the shoulder joint). 
  • If pain still continues or worsens even after physical therapy, your child's care team might discuss surgery as an option.  

When Should My Child Be Evaluated? 

Make an appointment with Connecticut Children's orthopedics experts if your child:

  • Has shoulder pain that lasts more than a few days
  • Has pain that keeps them from sports or daily activities
  • Cannot comfortably raise or use their arm
  • Notices shoulder weakness or ongoing discomfort, even if getting enough rest

Early evaluation can help determine the cause of shoulder pain and develop an appropriate treatment plan.