Shoulder Impingement
Shoulder impingement is a common musculoskeletal condition that causes pain when the shoulder structures become irritated during movement. High level laser therapy is a non-invasive treatment that may assist some patients by helping manage pain, supporting tissue recovery and improving comfort during rehabilitation.
Evidence suggests laser therapy may provide benefits for certain soft tissue conditions, although outcomes vary between individuals. A personalised assessment is important to determine whether high level laser therapy is appropriate. Health Wise Chiropractic provides evidence-informed shoulder care in Sunbury and Melton, combining treatment with rehabilitation strategies where suitable.
Shoulder impingement is a common cause of shoulder pain, particularly during reaching, lifting, overhead activities and exercise. High level laser therapy may help some people with shoulder impingement by supporting pain management, reducing sensitivity in irritated tissues and assisting the body’s natural recovery processes. However, the most appropriate treatment depends on the underlying cause of the shoulder problem and an individual assessment.
Shoulder impingement can involve irritation of the tendons, muscles, bursae or other structures around the shoulder joint. It is often associated with rotator cuff tendon irritation, changes in shoulder movement patterns, repetitive use or reduced shoulder strength and control.
At Health Wise Chiropractic, practitioners in Sunbury and Melton assess shoulder pain by looking at the complete picture, including movement, posture, muscle function and contributing factors. High level laser therapy may be recommended as part of a broader management plan that can include exercise rehabilitation, manual therapy, activity modification and education.
Early assessment and appropriate management may help improve function, reduce aggravating factors and support a safer return to normal activities.
What Is This Condition?
Understanding Shoulder Impingement
Shoulder impingement is a term commonly used to describe shoulder pain caused by irritation or compression of tissues around the shoulder joint during movement. It most often involves structures located beneath the acromion, which is a bony part of the shoulder blade that forms the roof of the shoulder joint.
The shoulder is a highly mobile joint that relies on the coordinated interaction of bones, muscles, tendons and ligaments. The main structures involved include:
The humerus – the upper arm bone that forms the ball of the shoulder joint
The scapula (shoulder blade) – provides the foundation for shoulder movement
The clavicle (collarbone) – connects the shoulder complex to the chest
The rotator cuff muscles and tendons – four muscles that stabilise and control shoulder movement
The subacromial bursa – a small fluid-filled structure that reduces friction between tissues
During normal shoulder movement, these structures glide smoothly. However, changes in shoulder mechanics, repetitive loading, inflammation, tendon irritation or reduced muscular control may contribute to pain and reduced function.
What Happens During Shoulder Impingement?
Shoulder impingement is often associated with irritation of the rotator cuff tendons, particularly the supraspinatus tendon, and surrounding soft tissues.
When the shoulder moves, especially during overhead activities, irritated tissues may become more sensitive. This does not necessarily mean that the tissues are being permanently damaged. Instead, the nervous system may become more responsive to movement, resulting in pain, stiffness or weakness.
Modern understanding of shoulder pain recognises that symptoms can result from multiple contributing factors, including:
Tendon health
Muscle strength and endurance
Shoulder blade movement
Posture and movement habits
Training load
Previous injuries
Work demands
Individual pain sensitivity
The term “impingement” is still commonly used clinically, although many experts now recognise that shoulder pain is often more complex than simple mechanical compression alone.
Acute Shoulder Impingement
Acute shoulder impingement symptoms may develop suddenly after:
A new exercise program
Heavy lifting
Repetitive overhead activity
A sporting injury
An increase in work demands
People with acute symptoms may experience sharp pain during specific movements, reduced range of motion and difficulty using the affected arm normally.
Early management often focuses on reducing aggravating activities while maintaining appropriate movement. Complete rest is usually not recommended because gradual loading and rehabilitation are important for recovery.
Chronic Shoulder Impingement
Persistent shoulder impingement symptoms may develop gradually over weeks or months. Chronic cases are often associated with:
Repeated overhead movements
Poor load management
Reduced shoulder strength
Altered movement patterns
Previous shoulder injuries
Ongoing irritation of tendons or surrounding tissues
Long-term shoulder pain may affect sleep, work performance, exercise participation and everyday activities such as dressing, reaching shelves or lifting objects.
Persistent symptoms should be assessed to determine the underlying cause and identify whether additional investigations or referral may be required.
Common Symptoms of Shoulder Impingement
Symptoms can vary depending on the structures involved, but common complaints include:
Pain when lifting the arm overhead
Discomfort reaching behind the back
Pain when lying on the affected shoulder
Aching around the outer shoulder or upper arm
Reduced shoulder strength
Shoulder stiffness
Clicking or catching sensations
Difficulty performing sporting or work activities
Reduced confidence using the affected arm
Pain may be felt in the shoulder itself or may refer into the upper arm. It is important to distinguish shoulder pain caused by local tissues from pain originating from the neck, nerves or other areas.
How High Level Laser Therapy May Help Shoulder Impingement
High level laser therapy (HLLT), also known as photobiomodulation therapy, is a non-invasive treatment that uses specific wavelengths of light to influence biological processes within the body. For people with shoulder impingement, high level laser therapy may be used as part of a broader treatment approach aimed at reducing pain, improving comfort with movement and supporting rehabilitation.
Shoulder impingement is not simply a problem of “wear and tear” or one structure being damaged. It often involves a combination of factors, including tendon sensitivity, muscle function, shoulder mechanics, activity demands and the way the nervous system processes pain signals.
Because of this, high level laser therapy is generally considered a supportive treatment rather than a standalone solution. The best outcomes are often achieved when it is combined with appropriate exercise, movement retraining, education and activity modification.
How High Level Laser Therapy May Help Shoulder Impingement
High level laser therapy (HLLT), also known as photobiomodulation therapy, is a non-invasive treatment that uses specific wavelengths of light to influence biological processes within the body. For people with shoulder impingement, high level laser therapy may be used as part of a broader treatment approach aimed at reducing pain, improving comfort with movement and supporting rehabilitation.
Shoulder impingement is not simply a problem of “wear and tear” or one structure being damaged. It often involves a combination of factors, including tendon sensitivity, muscle function, shoulder mechanics, activity demands and the way the nervous system processes pain signals.
Because of this, high level laser therapy is generally considered a supportive treatment rather than a standalone solution. The best outcomes are often achieved when it is combined with appropriate exercise, movement retraining, education and activity modification.
How Does High Level Laser Therapy Work?
High level laser therapy uses concentrated light energy delivered to targeted tissues. Unlike surgical lasers, therapeutic lasers do not cut or remove tissue. Instead, the light energy interacts with cells and may influence cellular activity.
The proposed biological effects of photobiomodulation include:
Supporting Cellular Energy Production
Laser light may stimulate mitochondria, which are the energy-producing structures inside cells.
This process may increase production of adenosine triphosphate (ATP), which is an important energy source used by cells during normal repair and function.
Improved cellular energy availability may help support the body’s natural recovery processes.
Modulating Inflammation
Inflammation is a normal part of tissue healing; however, prolonged or excessive inflammatory activity may contribute to ongoing sensitivity and discomfort.
Research suggests photobiomodulation may influence inflammatory pathways and chemical mediators involved in the inflammatory response.
For shoulder conditions involving irritated tendons or soft tissues, this may help reduce local sensitivity in some individuals.
Reducing Pain Sensitivity
High level laser therapy may influence pain through several possible mechanisms, including:
Reducing sensitivity of local nerve endings
Affecting inflammatory chemicals associated with pain
Supporting normal nerve function
Improving comfort during movement
Pain relief can allow patients to participate more comfortably in rehabilitation exercises, which are often an important component of shoulder recovery.
Supporting Soft Tissue Recovery
Tendons and other connective tissues have a relatively limited blood supply compared with muscles, meaning recovery can sometimes be slow.
Laser therapy may support tissue metabolism and circulation around treated areas. However, it is important to recognise that evidence varies depending on the specific condition, treatment parameters and individual patient factors.
What Does Treatment Feel Like?
Most patients find laser therapy comfortable.
During treatment you may notice:
Gentle warmth
Mild tingling
No pain
No vibration
No electrical sensation
Protective safety glasses are worn by both the practitioner and patient throughout treatment.
Treatment usually takes between 5 and 15 minutes, depending on the size of the treatment area and the severity of symptoms.
Most people can return to normal daily activities immediately afterwards.
Who May Benefit From High Level Laser Therapy for Shoulder Impingement?
High level laser therapy may be considered for people who have:
Shoulder pain associated with irritated soft tissues
Rotator cuff-related shoulder pain
Difficulty performing exercises due to discomfort
Persistent symptoms despite modifying activities
A preference for non-invasive treatment options
Pain that limits daily activities, work or sport participation
Patients who may respond well often include those who can combine treatment with:
Progressive strengthening exercises
Improved shoulder movement patterns
Workplace modifications
Gradual return to activity
Who May Not Be Suitable for High Level Laser Therapy?
High level laser therapy is not appropriate for every person or every type of shoulder pain.
It may not be recommended or may require medical clearance in situations such as:
Suspected cancer in the treatment area
Direct treatment over the eyes
Certain photosensitivity disorders
Some medication-related light sensitivities
Acute unexplained swelling or significant trauma
Suspected serious underlying pathology
A practitioner should review your health history before commencing treatment.
What Happens During Your Appointment?
At Health Wise Chiropractic, your first appointment begins with a comprehensive assessment to identify the true source of your shoulder pain. Not every painful shoulder is caused by shoulder impingement, so an accurate diagnosis is essential before treatment begins.
Comprehensive History
Your chiropractor will ask questions about:
When your shoulder pain started
How the injury occurred
Activities that aggravate or relieve symptoms
Previous shoulder injuries
Sporting participation
Occupation and work demands
Sleep disturbance
Medical history
Previous imaging or treatment
Understanding your history helps determine whether your symptoms are consistent with shoulder impingement or another condition such as a rotator cuff tear, frozen shoulder, arthritis or pain referred from the neck.
Physical Examination
A detailed examination may include:
Observation of posture
Shoulder range of motion
Rotator cuff strength testing
Functional movement assessment
Shoulder blade movement
Orthopaedic shoulder tests
Neck assessment where appropriate
Muscle palpation
Neurological screening if indicated
The aim is to identify which structures are contributing to your pain and whether any serious conditions require medical referral.
Individual Assessment
Your chiropractor will explain:
The likely diagnosis
Factors contributing to your symptoms
Expected recovery timeframe
Whether high level laser therapy is appropriate
Other recommended treatments
A personalised rehabilitation plan
If imaging or referral is required, this will also be discussed.
High Level Laser Therapy
If clinically appropriate, treatment may include high level laser therapy.
Protective eyewear is worn by both practitioner and patient.
The laser is applied over the affected tissues for several minutes using specific treatment parameters based on:
Your condition
Tissue depth
Area being treated
Stage of healing
Most patients experience little or no discomfort during treatment. Some notice a gentle warming sensation.
Additional Treatment
Depending on your presentation, your appointment may also include:
Manual therapy
Joint mobilisation
Soft tissue therapy
Rehabilitation exercises
Postural advice
Activity modification
Home exercise prescription
Aftercare
Following treatment you may be advised to:
Continue gentle shoulder movement
Perform prescribed rehabilitation exercises
Modify aggravating activities temporarily
Apply ice or heat if appropriate
Gradually return to normal activities
Most people can return to work or normal daily activities immediately after treatment.
Home Care & Exercises
Exercise is one of the most important parts of recovering from shoulder impingement. These beginner exercises should only be performed if comfortable and should be modified based on professional advice.
1. Pendulum Swings
Purpose
Reduce shoulder stiffness while maintaining gentle movement.
Instructions
Lean forward supporting yourself with one arm.
Allow the affected arm to hang freely.
Gently move the arm forwards/backwards, side to side and in small circles.
Repetitions
30–60 seconds.
Frequency
2–3 times daily.
Progression
Increase circle size as symptoms improve.
2. Scapular Retractions
Purpose
Improve shoulder blade control.
Instructions
Sit or stand tall.
Gently squeeze the shoulder blades together.
Hold without shrugging.
Repetitions
10–15 repetitions.
Frequency
2–3 sets daily.
Progression
Add a resistance band.
3. Isometric External Rotation
Purpose
Begin strengthening the rotator cuff.
Instructions
Stand beside a wall.
Bend the elbow to 90 degrees.
Push gently into the wall without moving the arm.
Hold
5–10 seconds.
Repetitions
10 repetitions.
Frequency
Daily.
Progression
Progress to resistance band exercises.
4. Wall Slides
Purpose
Improve overhead shoulder movement.
Instructions
Place both hands on a wall.
Slowly slide them upward.
Stop before pain significantly increases.
Slowly return.
Repetitions
10 repetitions.
Frequency
2 sets daily.
Progression
Increase height gradually.
5. Resistance Band Rows
Purpose
Strengthen the upper back and shoulder stabilisers.
Instructions
Attach a resistance band.
Pull elbows backwards.
Squeeze shoulder blades together.
Return slowly.
Repetitions
12–15 repetitions.
Frequency
2–3 sets, 3–4 days per week.
Progression
Increase resistance gradually while maintaining good technique.
These exercises should not significantly increase pain. If symptoms worsen or new symptoms develop, seek professional advice.
Prevention Tips
Although not every case can be prevented, the following strategies may reduce the risk of shoulder impingement:
Maintain Good Posture
Avoid prolonged slouched sitting and regularly change positions throughout the day.
Optimise Your Workstation
Keep keyboard and mouse close.
Position monitors at eye level.
Take movement breaks every 30–60 minutes.
Strengthen Your Shoulders
Regular strengthening of the rotator cuff and shoulder blade muscles improves shoulder resilience.
Warm Up Before Sport
Prepare muscles and joints before overhead sports or gym sessions.
Increase Training Gradually
Avoid sudden increases in weight, repetitions or sporting intensity.
Improve Upper Back Mobility
Thoracic mobility exercises may reduce unnecessary shoulder strain.
Use Correct Lifting Technique
Lift close to your body and avoid repeated overhead lifting where possible.
Sleep Comfortably
Avoid sleeping directly on a painful shoulder. Supporting the arm with a pillow may improve comfort.
Stay Physically Active
Regular exercise supports joint health and muscle function.
Manage Stress
Persistent stress may increase muscle tension and influence pain sensitivity. Regular movement, adequate sleep and relaxation strategies may assist overall recovery.
Recovery Timeline
Recovery from shoulder impingement varies depending on the severity of symptoms, the structures involved, how long the condition has been present and how consistently rehabilitation is followed. While high level laser therapy may assist with pain management for some people, recovery usually requires a combination of appropriate treatment, exercise and gradual return to activity.
Mild Cases (2–6 Weeks)
People with mild shoulder impingement that has developed recently often improve within several weeks, particularly when aggravating activities are modified early.
Management may include:
Activity modification
High level laser therapy where appropriate
Gentle mobility exercises
Early strengthening exercises
Education about shoulder loading
Many patients notice gradual improvements in pain and movement over this period.
Moderate Cases (6–12 Weeks)
Moderate cases may involve more significant tendon irritation, muscle weakness or reduced shoulder function.
Recovery often requires:
Progressive strengthening
Rotator cuff rehabilitation
Shoulder blade control exercises
Manual therapy where appropriate
High level laser therapy to assist symptom management
Gradual return to work or sport
Consistency with home exercises is one of the strongest predictors of successful recovery.
Persistent or Chronic Cases (3–12 Months)
Shoulder pain that has persisted for several months may require a longer rehabilitation period.
These cases often involve:
Reduced shoulder strength
Tendon changes
Altered movement patterns
Reduced confidence using the arm
Persistent pain sensitivity
Management typically focuses on gradually increasing the shoulder's capacity to tolerate everyday activities rather than simply eliminating pain.
Some patients require referral for imaging, a sports physician or an orthopaedic specialist if symptoms fail to improve or if significant structural injury is suspected.
Factors That Influence Recovery
Recovery varies between individuals and may be influenced by:
Age
General health
Diabetes
Smoking status
Fitness level
Occupation
Sporting demands
Duration of symptoms
Consistency with rehabilitation
Sleep quality
Stress levels
Previous shoulder injuries
Although many people recover well with conservative care, there is no guaranteed timeline. An individual assessment provides the best estimate of expected recovery.
Australian Statistics
Shoulder pain is one of the most common musculoskeletal complaints seen by Australian healthcare professionals.
Current Australian data indicates:
Approximately 1 in 4 Australians will experience shoulder pain at some point during their lifetime.
Shoulder pain accounts for a significant proportion of presentations to general practitioners, physiotherapists and chiropractors.
Rotator cuff-related shoulder pain, including shoulder impingement presentations, is the most common cause of persistent shoulder pain in adults.
Shoulder disorders become increasingly common after the age of 40 due to age-related tendon changes and cumulative loading.
Workers performing repetitive overhead tasks have a substantially higher risk of developing shoulder disorders.
Shoulder pain is a frequent cause of reduced work productivity and time away from physically demanding occupations.
Musculoskeletal conditions, including shoulder disorders, contribute significantly to Australia's overall burden of disease and healthcare expenditure.
Most people with shoulder impingement improve without surgery when managed with appropriate conservative care and exercise.
Sources include the Australian Institute of Health and Welfare (AIHW), Australian Bureau of Statistics (ABS), and contemporary clinical practice guidelines for shoulder pain.
Frequently Asked Questions
1. Can high level laser therapy cure shoulder impingement?
No. High level laser therapy is not considered a cure. It may help reduce pain and support recovery as part of a comprehensive treatment plan that usually includes rehabilitation exercises and activity modification.
2. Is laser therapy painful?
No. Most patients experience little or no discomfort during treatment. Some notice a mild warming sensation.
3. How many laser treatments will I need?
The number of sessions varies depending on the severity of your condition, how long symptoms have been present and your response to treatment. Your chiropractor will recommend an individual treatment plan after assessment.
4. Can laser therapy help rotator cuff injuries?
High level laser therapy may assist with pain management for some rotator cuff-related conditions. However, strengthening exercises and progressive rehabilitation remain important parts of recovery.
5. Is high level laser therapy safe?
When provided by appropriately trained healthcare professionals, high level laser therapy is generally considered safe. Protective eyewear is worn during treatment, and certain medical conditions may require precautions.
6. Will I need shoulder exercises as well?
Yes. Exercise rehabilitation is one of the most evidence-supported treatments for shoulder impingement. Laser therapy is typically used to complement—not replace—an exercise program.
7. Can I continue exercising with shoulder impingement?
In many cases, yes. Your chiropractor can advise which activities are appropriate, which should be modified temporarily and how to return to exercise safely.
8. Do I need imaging before starting treatment?
Not always. Many cases of shoulder impingement can be diagnosed through a detailed history and physical examination. Imaging may be recommended if a significant tear, fracture or other serious condition is suspected.
9. When should I seek urgent medical attention?
Seek immediate medical assessment if shoulder pain follows significant trauma, is associated with obvious deformity, inability to move the arm, fever, unexplained swelling, chest pain, severe weakness or numbness, or other concerning symptoms.
10. Can shoulder impingement come back?
Yes. Symptoms can recur, particularly if contributing factors such as poor shoulder strength, repetitive overload or movement patterns are not addressed. Ongoing strengthening and load management can help reduce the risk of recurrence.
Why Choose Health Wise Chiropractic?
At Health Wise Chiropractic, we believe effective shoulder care begins with understanding the individual—not just the diagnosis.
Our experienced practitioners take the time to identify the underlying factors contributing to your shoulder pain before recommending treatment. If high level laser therapy is appropriate, it is integrated into a personalised management plan that may also include hands-on care, rehabilitation exercises, movement education and practical advice to support long-term recovery.
We focus on evidence-informed care that aligns with current clinical guidelines, recognising that every patient responds differently and that successful outcomes often require a combination of treatments rather than a single approach.
With modern clinics in Sunbury and Melton, convenient online bookings and a strong emphasis on patient education, we aim to help you better understand your condition and confidently return to work, sport and everyday activities.