Shoulder Impingement Syndrome is a common shoulder condition that involves the rotator cuff tendons, which can become inflamed, irritated or pinched as they pass between the acromion process of the scapula and the head of the humerus. Symptoms include pain, weakness and a loss of range of motion of the shoulder especially with overhead movements.  This condition can be multifactorial and careful examination is necessary to determine the root cause of the impingement. Factors that can play a role are bony structures, osteoarthritic spurs and variations in the shape of the bones. Thickening or calcification of the surrounding ligaments and loss of function of the rotator cuff muscles due to injury or improper motor patterns are also possibilities that can allow the head of the humerus to move superiorly, resulting in impingement like symptoms.  Treatment of this condition must incorporate the proper rehabilitation program and the causative tissues need to be identified and addressed with soft tissue techniques, acupuncture, graston, and or chiropractic care.