Impingement / Bursitis | Ultrasound guided Injections, Surgery, Physiotherapy, Treatment of impingement syndrome

Rotator cuff tendinopathy and Sub acromial bursitis leading to Subacromial Impingement

What is it?

The four muscles that raise and lower the arm (and their respective tendons) are collectively known as the rotator cuff. The rotator cuff lies under the roof of the shoulder (an extension of the shoulder blade known as the acromion). The space between the acromion and the rotator cuff tendons is filled by the subacromial bursa. This bursa is a fluid filled sac that allows for smooth gliding of the rotator cuff under the acromion with overhead movements of the shoulder.
Pathologies that could directly affecting the rotator cuff such as:
1. Rotator cuff strain
2. Partial or full thickness tear
3. Calcific tendonosis
4. A tendinopathy due to chronic overuse.


Treatment of impingement syndrome involves:
1. Painkillers and anti-inflammatory medications
2. Physiotherapy – the key part of management to work on good posture, shoulder blade positioning and strengthening of the weakened rotator cuff muscles
3. Ultrasound guided Injections – reduces inflammation and control the pain, allows the rotator cuff muscles a chance to recover and improve with the exercises
4. Surgery – Rarely Surgery is required – the goal of any surgery to reduce the effects of impingement, by increasing the amount of space between the acromion and the rotator cuff tendons, which will then allow for easier movement and less pain and inflammation. The operation performed is Arthroscopic Subacromial Decompression (ASD)


• Avoid excessive overhead activities.
• Strengthen your shoulders and do not try to play or work through the pain.