Shoulder Impingement | North Vancouver

That's the painful arc, and it's the classic fingerprint of impingement. The space under the acromion is narrowest as the arm passes through roughly shoulder height, so that's where the tendon gets pinched. Below and above that range there's more room, so it can feel fine. The pattern is part of how we confirm what's going on.

Cutting back on the volume that flares it (a week of painting ceilings, a sudden jump in swim laps) makes sense short-term. But avoiding overhead reach entirely tends to leave the shoulder weak and the pinch waiting. The fix is restoring the mechanics so the space stays open, then rebuilding the reach. We'll set what to back off and what to keep doing.

Almost never permanently. North Shore climbers and lifters are a big part of who we see for this. The goal is to fix the scapular timing and load tolerance so your shoulder handles the volume, then phase you back into pressing and overhanging holds. We adjust the plan to what your sport actually demands.

Yes, direct billing for most major extended-health insurers, plus ICBC and WorkSafeBC, and we handle the paperwork. Shoulder impingement often builds up from a long week of overhead reaching, overhead gym work, or climbing, so it isn't always a straightforward extended-health claim. Whatever the source, we sort out the right coverage and coordinate the claim so you can focus on the rehab.

Shoulder impingement happens when the rotator cuff tendon and the small fluid sac cushioning it get compressed against the bony roof of the shoulder as your arm lifts. Most of the time the real problem isn't the space itself, it's how the shoulder blade moves. When the scapula doesn't tilt and rotate out of the way as the arm climbs, the gap under the acromion stays narrow and the tendon keeps getting nipped.

Treatment centres on scapular retraining to restore the upward rotation and posterior tilt that reopens the space under the acromion, paired with manual therapy to free a stiff posterior capsule. We add graded loading through the painful arc, starting with isometrics and building toward full overhead reach, plus posture and workstation coaching so a desk job doesn't undo the progress between visits.

Impingement caught early often eases noticeably within 4 to 6 weeks once scapular control improves and the irritating overhead volume is managed. Cases that have been grumbling for months, or where the tendon has already become tendinopathic, take longer and sometimes benefit from shockwave. Your physiotherapist sets the next milestone after assessing your painful arc.