Impingement refers to abnormal rubbing of the tendons against the shoulder blade end (acromion). This can occur due to weak cuff muscles (age) that are unable to keep th ball contained or due to bony prominences of acromion irritating the tendon. Symptoms : Pain with overhead activity ( painful arc), reaching back and pain on sleeping on the same side. Treatment : Initial conservative – physio and subacromial injections. Resistant cases : Arthroscopy, debridement, subacromial bursectomy ( removal of the inflamed bursa) and acromioplasty (smoothening of the undersurface of the acromion bone to reduce the irritation on the tendon.