Shoulder impingement is a very common issue. You may be experiencing it if you feel a pinching sensation at the top of your shoulder when reaching overhead. It’s prevalence is found in both athletic and and non-athletic groups. Physical therapy is a great place to start when addressing this pain. Exercises for shoulder impingement target the direct cause of the impingement you are experiencing. By integrating therapeutic exercises, you can improve your range of motion and experience less pinching! This article will review what causes shoulder impingement, how physical therapy can help, and what exercises you can try to help reverse your shoulder impingement for pain free movement.
Take me straight to the exercises!
**This is not medical advice. Please consult your medical provider for more information.
What is Shoulder Impingement?
The shoulder is a complex joint where everything must be working in tandem and in sync. If not, you can injure yourself or experience problems like shoulder impingement.
Shoulder impingement occurs when the space where the rotator cuff tendons and the scapula (shoulder blade) meet becomes too narrow. The tendons then become irritated or inflamed. When you reach up overhead, the narrowing of this space causes a pinch-like pain sensation where the tendons are irritated. This can develop with repetitive overhead activities or poor mechanics. Poor mechanics can stem from multiple issues, including rotator cuff weakness, overly tight muscles, and poor posture.
Signs and Symptoms
Symptoms can range from a sharp, sudden pain when lifting the arm or a constant, dull ache, even when not moving the arm. You might experience pain when sleeping or when lying on the affected side. Strength can sometimes be affected. When the pain is present, its common to not use your arm as much. Because you aren’t using your arm as much, naturally you lose strength over time.
A diagnosis will usually come from your doctor after examining your shoulder. They will typically look at your range of motion, strength, and watch how your shoulder blade moves. Some special tests can also be performing to help rule in and rule out shoulder impingement.
Imaging such as X-rays or MRIs are not necessary, but they can give some insight if there are any structural issues within the shoulder. In some cases, shoulder impingement can come from structural changes of the acromion, though this isn’t as common.
How Physical Therapy Can Treat Shoulder Impingement
Treating shoulder impingement becomes easy once you figure out the cause. Understanding the mechanics of the shoulder is crucial when it comes down to this.
As discussed earlier, shoulder impingement occurs when the space where the rotator cuff tendons and the scapula meet becomes too narrow. To address this, more space needs to be created within this area so the tendons do not become irritated or “pinched.” This is where understanding the mechanics of the shoulder comes into play.
A physical therapist will be able to assess your movement to observe what your shoulder blade and other parts of your upper quarter are doing when you are reaching overhead. They can also test strength of certain muscles and muscle groups and test if other muscles are tight. All of these assessment give an overall view of what needs to be addressed through exercise in order to normalize your biomechanics when moving your arm.
Physical Therapy Exercises for Shoulder Impingement
Strengthening the rotator cuff and enhancing shoulder stability is essential. Integrating shoulder rehab exercises into your routine can significantly improve your shoulder health. These exercises for shoulder impingement can also be used to reduce the risk of developing future injuries, including impingement itself.
Latissimus Dowel Stretch
You will use a dowel, cane, broomstick, or any other similar piece of equipment laying around the house to help you with this exercise. You will need to kneel, so place something under your knees if you need a little additional support for comfort.
While kneeling, place your elbows up on a supportive surface near shoulder height. Hold the dowel in your hands with palms facing up. Your shoulders, elbows, and wrists should all be in alignment – don’t allow your elbows to drift outside of your wrists.
Sink your hips backwards towards your feet. This will raise your elbows up higher than shoulder height. You may begin to feel a stretch at this point. You may feel that your hands want to drift inwards. Make sure to hold the dowel firmly in your hands to keep your arms in neutral alignment.
This stretch may target multiple areas depending on where you are stiff. You may feel this in the back of the shoulders near the shoulder blades, down through your lats, or in your thoracic spine. Hold the stretch for 30 seconds and repeat 2 more times.
Active Posterior Cuff Stretch
Start by lying on your affected side with your arms extended and at shoulder height. Reach your top arm forward as your trunk starts to slowly rotate allowing you to reach even further. You should feel a stretch in the back of your shoulder on the side you are lying on. Slowly back off the stretch and return to the starting position. Perform 20-30 repetitions.
Pec Minor Doorway Stretch
You will use a doorway or edge of a wall for this stretch. Place the shoulder you want to stretch right in the doorway, as if the doorway is blocking you from moving forward. If your shoulder is tender sitting against the doorway, place a small towel between your shoulder and the doorway for comfort.
If you are stretching the right shoulder, take a small step forward with your right foot. Without allowing your shoulder to move (because it is stopped by the doorway), very gently rotate your body to the left until you feel a stretch. You should feel this stretch in the front of your chest, mostly where your shoulder is up against the doorway. Hold for 15-30 seconds and repeat. You can also repeat this on the other side.
Serratus Wall Plank
Place your forearms on the wall, similar to if you were trying to hold a plank on the ground. To make this more challenging, step your feet away from the wall so your body is in more of a diagonal position.
Your elbows should be directly in line with your shoulders. Keeping your shoulders down (not letting them shrug up towards your ears), press into the wall with your forearms as if you are trying to push your body away from the wall.
Hold this pushing sensation for up to 30 seconds and perform 2-3 sets. For more of a challenge, hold it up to an entire minute.
“Y” Lift Off
Start by standing facing the wall. Your arms will be extended in a “Y” position. Keeping your arms in this position, try to lift your arms off the wall by a couple inches. Really work to squeeze your shoulder blades together and down while doing this. You should feel this through your upper back between your shoulder blades. If you are able to, hold this position for up to 5 seconds. If not, briefly pause and lower your arms back to the wall before repeating again. Complete 3 sets of 10 repetitions.
Incorporating Daily Habits for Shoulder Health
When it comes down to it, pain from shoulder impingement will start to alleviate when shoulder mechanics are working optimally. In order to normalize your shoulder mechanics, consistency is key.
Start by incorporating the exercises for shoulder impingement listed above. Perform them on a daily basis. While these exercises are important, it’s more than just doing the exercises that will help you improve. It’s about learning how to move differently. My goal as a physical therapist is to teach you to move in a different way so you don’t experience the same symptoms you’re currently feeling.
Move With Intention
On top of the exercises, pay attention to how you move during the day. Every time you raise your arm up overhead, do you notice your shoulder shrugging towards your ear or the front of your shoulder jutting forward? Are you rounded in your upper back or is your chin and head learning far forward? In this day and age, this type of posture is all too common around us. The environment we now have with electronics every way we look has set us up for postures that are not optimal. Oftentimes, this is what drives chronic pain and injuries in our body that seem to “come out of nowhere.”
If you can start making small changes with how you move, this could speed up your recovery process. Try this: every time you reach overhead, slow down your movement and think about what you feel or see. Keep your shoulder blades down and back in your back pockets. As you reach upwards, try to keep your shoulder from elevating excessively up towards your ear. Your shoulder might move a little bit, but we don’t want you shrugging up towards your ear. Learning this crucial movement can help a lot!
Reduce Repetitive Stress
One other thing to pay attention to is how often repetitive movements are performed, as this can be a factor that increases your chance of developing shoulder impingement. Do you have a job where you are using your arms repetitively in one position? Can you pinpoint something you do around the house on a consistent basis that could add extra stress to your shoulders?
While we can’t always control what we can and can’t do (i.e.: I can’t force you to not do your job that requires your arms to be up overhead for long periods of time), paying attention to how much we do things can offer valuable insight. If this is something you can control, cut back on some of the tasks at home or in your daily life to give your arm a break. When dealing with a problem related to repetitive stress, a short break can occasionally help alleviate pain.
Monitoring Progress and When to Seek Professional Help
How do you know when it might be time to seek professional help? Listening to your body is paramount.
When you first start to feel the symptoms in your shoulder, take a couple of days to make sure it isn’t something that will go away on it’s own. If symptoms have stuck around for some time and aren’t going away, it might be time to check in with a medical professional. If you can’t move your arm at all, go see your healthcare practitioner.
A physical therapist can offer personalized guidance and a program tailored specifically to what you need. Adjustments can be made safely to your program to keep you progressing along, while also reducing the risk of further injury.
Paying attention to pain levels, shoulder mobility, strength, and functional use of your arm are all good indications of whether you should continue with your exercises or take it easy. If you experience increased pain that is sharp while doing your exercises for shoulder impingement, speak with your physical therapist. They will be able to determine what is the best course of action for you, whether it is to rest, modify, or maintain exercises.
Additional Tips and Advice for Managing Shoulder Impingement
There are a multitude of things you can do aside from rehab exercises for shoulder impingement. Here are a few other key tips that will be useful in your recovery journey.
Posture is Paramount
Think of posture as your foundation. If you have a faulty foundation, it sets you up for increased risk of injury with all other things that you do. You can pay attention to posture and help reduce your shoulder impingement symptoms all in one!
Avoid slouching. Sit up tall. And keep your shoulders down and back in your back pockets. Use mirrors to your advantage and check your posture any time you walk past one. Frequently check in with yourself throughout the day for postural adjustments.
This also applies to ergonomic setup. You should check in with your posture whether you are sitting or standing. And if you have a desk job, work from home, or find yourself sitting for a large majority of the day, then this is even more important. Think about how many minutes to hours you are sitting during the day. If you have poor posture throughout the entirety of this time, these are all micro stresses that can be placed on your shoulder and other areas of your body. Do yourself a favor and take care of your body, even when you don’t feel like you aren’t doing much.
Want More on Posture? These Articles Will Be Helpful:
- How to Fix Rounded Shoulders
- What You Should Know About Tech Neck: Relieve the Pain
- 5 Great Stretches and Exercises to Alleviate Tension Headaches
Pay Attention to Your Symptoms
Your symptoms should drive your decisions throughout the day. If you pain levels are manageable and tolerable, you are probably safe to keep doing what you are doing. Just keep in mind that repetitive stress can add up over time if you don’t do anything about it.
If you feel pain is getting worse with certain activities or movements of your arm, cut back or abstain from them altogether until you get your shoulder checked out by a medical professional. Your body will let you know that something is wrong. If the pain keeps increasing, this is your sign to take it easy.
Other Related Articles on Shoulder Pain
- The Exercise You Need for Pinching in Shoulder When Reaching
- The Shoulder Warm-Up You Need Before Lifting
- Unlock Your Shoulder’s Full Potential with Serratus Anterior Workouts
- Physical Therapy Exercises for Shoulder Pain: What You Should Know
- How to Improve Shoulder Range of Motion
- 5 Important Shoulder Rehab Exercises for Optimal Function
- Shoulder Strength and Stability: A Beginner’s Guide
TL;DR
Shoulder impingement occurs when the space where the rotator cuff tendons and the scapula (shoulder blade) meet becomes too narrow. The tendons then become irritated or inflamed. Exercises for shoulder impingement aim to increase this space to relieve the stress on the rotator cuff tendons. This article reviews what causes shoulder impingement, how physical therapy can help, and what exercises you can try to help reverse your shoulder impingement for pain free movement.
Tera Sandona is a licensed Doctor of Physical Therapy (DPT) and the founder of PT Complete. She helps high-achieving women break out of cycles of chronic pain, stress, and burnout through her Regulate and Rebuild Method, a sequenced approach that addresses the nervous system first and builds strength second. Her work focuses on helping women finally understand their bodies, rebuild strength, and create lasting resilience that fits real life.
