#67 Shoulder impingement with Professor Jeremy Lewis

Shoulder pain management is undergoing a paradigm shift, moving away from outdated structural models toward a functional, biopsychosocial perspective. Professor Jeremy Lewis, a leading researcher in musculoskeletal healthcare, highlights that the long-held belief that poor posture causes impingement is unsupported by evidence, and that subacromial impingement itself is often a clinical illusion. Instead of focusing on pathoanatomical diagnoses, clinicians should adopt the term "rotator cuff-related shoulder pain" to better reflect the complexity of the condition. Effective care prioritizes shared decision-making, behavioral change, and lifestyle modifications—such as sleep and activity management—over elective surgery. By addressing the biochemical and functional drivers of pain rather than just structural abnormalities, physiotherapy can better support patient recovery. This evolution emphasizes that the future of the profession lies in fostering patient flourishing through evidence-based, conservative management rather than relying on potentially unnecessary surgical interventions.