What is shoulder impingement?
Subacromial space anatomy
The subacromial space is the narrow area between the head of the humerus and the acromion, through which the rotator cuff tendons and subacromial bursa pass. Shoulder impingement (or subacromial impingement) is a pinching of these structures within this space during arm-raising movements, causing pain and local inflammation.
Why does this impingement appear?
Shoulder impingement appears when the subacromial space narrows, either because of weakness in the muscles that actively depress the head of the humerus (rotator cuff), a rounded shoulder posture that alters the shoulder blade’s position, or, more rarely, a particular bone shape of the acromion.
Which sports contribute to shoulder impingement?
All sports involving repeated arm-raising carry a risk of this impingement:
- Swimming and water polo
- Tennis and badminton
- Volleyball and handball
- Weight training with overhead presses
- Weightlifting
- Crossfit with repeated overhead movements
Treating shoulder impingement in rehab with a sports physio
The goal of treatment is to enlarge the subacromial space by strengthening the muscles that actively depress the head of the humerus and by correcting shoulder blade posture, to remove the mechanical cause of the impingement.
- 1Reducing pain and managing load
- 2Shoulder and shoulder-blade mobility
- 3Isometric strengthening
- 4Progressive concentric strengthening
- 5Eccentric strengthening
- 6Rotator cuff work
- 7Correcting sporting technique
- 8Strengthening under sport-specific load
- 9Progressive return to your sport
- 10Return to competition
Why the physio’s initial assessment matters
During the initial assessment, the physiotherapist aims to identify the movements that reproduce the pain, your overall posture, and your sporting history and any muscle imbalances contributing to the narrowing of the subacromial space.
“Shoulder impingement is resolved by freeing up space, not by avoiding movement.”
Strengthening, the cornerstone of treatment
Strengthening the rotator cuff, particularly the muscles that depress the head of the humerus, combined with strengthening the shoulder blade stabilisers, durably enlarges the subacromial space and removes the cause of the impingement rather than just treating the symptoms.
In brief
- Strengthening the rotator cuff
- Strengthening the shoulder blade stabilisers
- Associated postural correction
- Gradual return: mobility, then load, then sport
Ready to take your shoulder impingement seriously?
Start the HOPP programme designed by sports physios.
Should you rest or keep playing sport?
Total rest is generally not necessary. It’s better to temporarily adapt your activity by reducing the overhead movements that clearly reproduce the pain, while starting to strengthen the cuff as soon as possible.
Think you might have a different shoulder injury?
Take your free test in 3 minutes flat.
When should you see a specialist for shoulder impingement?
If pain persists for more than three to four weeks despite adapting your activities, or if it comes with a clear loss of strength, a medical opinion is recommended to rule out structural rotator cuff damage.
The HOPP care programmes to treat your shoulder impingement and get back to sport
This impingement requires progressively rebalancing the forces around the shoulder. HOPP offers you a precise exercise programme, allowing you to get back to your activities as quickly as possible.
The programme runs from 3 to 9 weeks depending on the injury and ends with a reconditioning phase allowing a return to competition in the best possible conditions. Each programme is designed by the HOPP team, made up of two sports physiotherapists who are experts in assessing and treating athletes. You’ll also find theoretical content throughout your progression, so you master every aspect of your recovery and can adjust your treatment independently. If needed, our team of physiotherapists is on hand to support you.
Essential
FROM INJURY TO
BACK TO YOUR ACTIVITIES
59€
One-time payment
“AT YOUR OWN PACE WITH
DAILY ADAPTATION”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility
- Strengthening
- Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
Performance
TO GET BACK TO SPORT
IN THE BEST CONDITIONS
79€
One-time payment
“GET BACK TO YOUR LEVEL
WITHOUT RISK OF RELAPSE”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility
- Strengthening
- Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
- + 4-week return-to-play plan with 6 difficulty levels
Expert
PERSONALISED VIDEO-CALL
SUPPORT, ANY TIME
149€
One-time payment
“A PHYSIO
WHENEVER YOU NEED”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility, Strengthening, Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
- + 4-week return-to-play plan with 6 difficulty levels
- + 2 video calls with an expert sports physio / return check-up
A programme that adapts to you every day
Every day, how you feel (RPE) is factored in to automatically adjust the rest of your programme: more load if all is well, a bit less if your shoulder is complaining. This daily personalisation is what makes the difference compared to a fixed, paper-based programme.
Ready to start your programme?
Join the HOPP support programme designed by sports physios.
F.A.Q
Does the HOPP programme replace a medical consultation?
No. HOPP is a support and rehab tool designed by sports physiotherapists, but it doesn’t replace a doctor’s opinion. If in doubt, or if the pain persists, see a health professional.
Is the programme suited to all sporting levels?
Yes. Every programme is personalised to your sport, your level and how you feel each day, whether you’re a recreational athlete or preparing for competition.
Can I keep playing sport with shoulder impingement?
In most cases, yes, by temporarily adapting your volume and avoiding overhead movements that reproduce the pain, while starting to strengthen the cuff in parallel.
How long does it take to recover from shoulder impingement?
A structured programme generally gives a clear improvement within a few weeks, with a full return to sport after several weeks of progressive strengthening.
Does shoulder impingement need surgery?
Rarely as a first option. The vast majority of shoulder impingements improve markedly with well-conducted rehab, with surgery only considered if well-conducted conservative treatment fails.
