Shoulder impingement syndrome is compression and inflammation of the rotator cuff tendons and bursa in the subacromial space, the tendons are irritated but intact. A rotator cuff tear is actual tearing of the tendon fibers, partial or complete. However, these often coexist: chronic untreated impingement progressively damages tendons leading to tears (Stage 3 impingement). Impingement symptoms: painful arc shoulder, night pain, weakness but can lift arm. Rotator cuff tear symptoms: similar but often more severe weakness, sometimes inability to lift arm depending on tear size. MRI distinguishes between the two. Treatment differs: impingement primarily conservative, large tears often need surgery.

Yes, 70-80% of shoulder impingement cases heal with conservative treatment, physical therapy, shoulder impingement exercises, anti-inflammatory measures, and activity modification. How long does shoulder impingement take to heal without surgery? Typically 12-16 weeks of dedicated therapy. Factors favoring non-surgical healing: acute onset (caught early), no significant bone spurs on X-ray, good rotator cuff tendon quality on MRI, patient compliance with therapy, addressing biomechanical factors. Surgery only needed when: bone spurs cause mechanical impingement, conservative treatment failed after proper 3-6 month attempt, progressive tendon degeneration, work/sport demands require it.

The best exercises for shoulder impingement focus on three areas: (1) Rotator cuff strengthening: external rotation with resistance band, internal rotation exercises, strengthens dynamic stabilizers preventing upward humeral head migration. (2) Scapular stabilization: scapular retraction exercises, wall slides, rows, corrects poor shoulder blade mechanics contributing to impingement. (3) Posterior capsule stretching: cross-body stretch, sleeper stretch, tight posterior capsule alters mechanics and worsens impingement. Shoulder impingement stretches are essential component. CRITICAL: proper technique is essential, improper exercise worsens impingement. Work with physiotherapist experienced in shoulder conditions for proper progression. Avoid: overhead pressing, heavy lifting, exercising through pain.

Frozen shoulder vs impingement: Key differences are: Range of motion, impingement has good passive ROM (someone else can move your arm fully), frozen shoulder has severely restricted passive ROM (even when relaxed, arm won't move). Painful arc shoulder, impingement has painful arc between 60-120 degrees, frozen shoulder has global pain and stiffness at all ranges. Night pain, both have night pain but frozen shoulder often more severe. Onset, impingement gradual from overuse, frozen shoulder often spontaneous or post-injury. However, they can coexist, chronic impingement can lead to secondary frozen shoulder from disuse. Accurate diagnosis requires examination by shoulder specialist.

Subacromial bursitis is inflammation and thickening of the bursa (fluid-filled cushion) in the subacromial space. Shoulder bursitis and impingement syndrome often occur together, in fact, bursitis is usually part of impingement syndrome. The relationship: (1) Impingement compresses the bursa causing inflammation (bursitis). (2) The inflamed swollen bursa takes up space, worsening the impingement. (3) This creates a vicious cycle. Treatment is essentially the same: rest, NSAIDs, physical therapy, corticosteroid injections (very effective for bursitis), surgical bursa excision if conservative treatment fails. So while technically different anatomically, shoulder bursitis and impingement are almost always treated together as one condition.

Sleeping after rotator cuff surgery requires a reclined position for 4-6 weeks a recliner is ideal, otherwise use a wedge pillow at 45 degrees. Lying flat increases pressure on the repair and pain. Ice every 2 hours for 20 minutes significantly reduces swelling during early recovery.