Column September 2, 2025
Shoulder Impingement Syndrome — That Catching Feeling When You Lift Your Arm
Hyo-seop Kim
Chief Director
Table of Contents
What is shoulder impingement syndrome
Shoulder impingement syndrome is a condition in which the rotator cuff tendons or the subacromial bursa get pinched beneath the acromion when the arm is lifted, causing pain. A characteristic finding is a "painful arc" between roughly 60° and 120° of elevation. In Korean medicine, it is interpreted as shoulder-arm pain (肩臂痛) caused by qi and blood stagnation in the meridians.
Causes and contributing factors
- Acromial shape: A hook-shaped (type III) acromion congenitally narrows the subacromial space, making impingement more likely.
- Postural problems: A rounded-shoulder posture tilts the scapula anteriorly and narrows the subacromial space.
- Muscle imbalance: Overactivity of the upper trapezius along with weakness of the lower trapezius and serratus anterior leads to scapular dyskinesia.
- Repetitive overhead motions: Painting, swimming, volleyball, and other activities that repeatedly raise the arm overhead are common causes.
Examination and diagnosis
- Neer test: With the scapula stabilized, passively elevating the arm forward elicits subacromial impingement pain.
- Hawkins test: With the arm raised to 90°, internal rotation reproduces impingement pain.
Korean medicine treatment
- Acupuncture: Jianyu (LI15) and Jianliao (TE14) are the acupoints closest to the subacromial space and are key treatment points to release local inflammation and adhesions. Electroacupuncture across the two points enhances analgesia and blood-flow promotion.
- Pharmacopuncture: Anti-inflammatory pharmacopuncture is administered around the subacromial bursa to directly treat bursitis.
- Chuna manipulation: Restores normal scapular movement patterns and corrects the upper thoracic spine to improve rounded shoulders. This widens the subacromial space and reduces impingement.
- Herbal medicine: Seogyeong-hwalhyeol-tang (舒筋活血湯) is used as the base formula, with the addition of Ganghwang (薑黃, turmeric/Curcuma) and Haedongpi (海桐皮, Erythrina bark), which are effective for shoulder-arm pain.
Scapular stabilization exercises
Alongside treatment, scapular stabilization exercises that strengthen the serratus anterior and lower trapezius are essential. Daily wall push-up plus, band external-rotation exercises, and scapular retraction exercises can fundamentally resolve the underlying cause of impingement.