Impingement syndrome occurs when the shoulder bones impinge upon the shoulder tendons or bursa. While common in older adults, impingement syndrome can occur as a result of repeated overhead activity from painting, lifting weights or heavy objects, swimming, tennis, and pitching. The most common symptoms of impingement syndrome include pain when reaching overhead that interrupts daily activities. If left untreated, impingement syndrome may cause the tendons and bursa to swell, leading to tendinitis and bursitis. In severe cases, the rotator cuff tendons may begin to fray. Treatment for impingement syndrome usually involves taking anti-inflammatory medication for six to eight weeks; avoiding activities that cause pain; and stretching gently. Physical therapy also may be beneficial. A physical therapist will be able to provide a comprehensive and custom exercise and stretching program to help increase strength, flexibility, and range of motion in the muscles in the shoulder, without causing further injury. He or she also may use modalities such as ultrasound and cold or heat therapy to reduce pain and provide education to prevent a recurrence. Acupuncture—in conjunction with physical therapy—also may be helpful in treating impingement therapy. If conservative treatment fails, corticosteroid injections or surgical intervention to repair a torn rotator cuff may be necessary. Impingement also can occur in the ankle, back, hip, and knee.