Explaining Shoulder Impingement Syndrome

Pinching, clicking, popping, general weakness during practice or competition. These are among the most common symptoms experienced among overhead athletes. By themselves, each symptom does not serve as an indicator of injury. In overhead athletes, signs and symptoms of this nature can jeopardize their ability to be effective in their sport – contributing to more serious injuries, sidelining them from participation, and keeping them out of the fight.

FanGraphs.com’s MLB injury survey data from 2023-2025 shows year-to-year increases in documented cases of Shoulder Impingement: with cases accounting for 4% of shoulder injuries in 2023 to 18% in 2025. With numbers on the rise at the Major League level, it is easy to assume the same rates are prevalent at all lower levels – particularly in the youth space. For greater detail on the topic, we must define it first.

So what is Shoulder Impingement?

Shoulder Impingement Syndrome (SIS) – most commonly Internal Shoulder Impingement – develops when the space between the acromion (top of shoulder) and the clavicle (collarbone) shrinks. The result of this shrinkage causes the rotator cuff (RTC) muscles, bursa, and/or tendons to rub against the bones closing on top of them; like a tall person continuously brushing their head against the ceiling. Over time, this development increases pain and decreases function.

In overhead athletes, pain usually occurs as the arm reaches anywhere between 60° and 120°; becoming more symptomatic in “lay back” or as the ball reaches their ear while throwing.

How does it develop?

Great question, broad answer.

SIS is commonly noted as an underlying cause of RTC injury and bursitis. As a result, the main cause is directly correlated to the repetitive use of the shoulder and said RTC muscles. Overuse coupled with a lack of specific strength, endurance, and scapular (shoulder blade) control usually serves as the recipe for the dysfunction’s development over time.

How do we prevent/fix it?

Typical treatments consist of:

• Formal Evaluation

• Pain Medication

• Structured Rehabilitation Program Emphasizing:

  • Improving joint and muscular mobility (to open up the joint space)

  • Muscular strength and endurance (to re-establish scapular stabilization)

  • Improving movement efficiency (to reinforce proper movement patterns once pain-free).

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