The onset of symptoms is typically related to an episode of overuse and the symptoms progress over time. The main symptoms of shoulder impingement are: Pain with overhead arm use Difficulty reaching up behind the back Shoulder weakness Decreased range of motion Left untreated, the condition can lead to rotator cuff tendonitis, bursitis, or rotator cuff tear Pain associated with shoulder impingement Difficulty reaching up behind the back Pain with overhead use of the arm Shoulder weakness Decreased range of motion Left untreated, the condition can lead to rotator cuff tendonitis, bursitis, or rotator cuff tear