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Patient Presentation

Although impingement symptoms may arise following trauma, the pain more typically develops insidiously over a period of weeks to months. The patient’s history will usually consist of pain with overhead activity, reaching, lifting, and throwing.

They may have a job or recreational activity that involves repetitive overhead movement (painting, assembly work, tennis). A long day of overhead activity may increase symptoms to the point where the patient seeks medical attention.

The pain usually occurs over the anterolateral aspect of the shoulder, and the patient may point to this specific area. It may radiate down to the deltoid insertion. Very often the patient may report pain at night, exacerbated by lying on the involved shoulder or sleeping with the arm overhead. A complete history and physical is essential to making a diagnosis of subacromial impingement.

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