Let’s be honest, shoulder Impingement syndrome can be a pain in the butt (or the arm rather). It can be extremely painful and limit you in just about every activities that you love to participate in. If you’ve ever dealt with shoulder impingement of the rotator cuff then you know exactly what I mean. But what does shoulder impingement even mean?

In this article we are going to go highlight everything you need to know about shoulder impingement including some frequently asked questions about shoulder impingement, and eleven very specific physical therapy exercises for shoulder impingement. Find our guide to helping your shoulder impingement below.

What is “shoulder impingement”?

Simply put, shoulder impingement (also considered shoulder bursitis or shoulder tendonitis) is a condition that occurs in the shoulder joint when we have weakness in the rotator cuff muscles, loss of range of motion (stiffness in the shoulder), or instability of the shoulder while also performing repetitive activities or a lot of overhead arm movements (i.e. baseball pitchers, volley ball players, etc.). When we have factors like weakness or stiffness in the shoulder joint you can have a lack of stability in the joint which creates too much movement in the shoulder joint when lifting overhead. Overtime this excessive movement of the upper arm bone creates unnecessary pressure on the structures that sit within the shoulder under the acromion (the bone on the tip of your shoulder). This excessive compression of the rotator cuff tendons and the bursa will eventually lead to inflammation, pain, and possibly even a torn rotator cuff. You don’t have to have all of these conditions to get impingement, but they all can contribute to developing shoulder impingement.

How do you fix shoulder impingement?

Avoiding painful movements of the shoulder, non-steroidal anti-inflammatory medications (NSAIDS), ice pack or heat pack, rotator cuff specific strengthening exercises, reducing overhead activities or use the opposite hand, and maintaining good posture can all be helpful in fixing shoulder impingement. But truly, before you are able to fully fix shoulder impingement you have to understand the causes of shoulder impingement. Seeing a shoulder specialist (physical therapist, orthopedic surgeon, etc.) can help accurately diagnose your shoulder problem and from there you can create a proper plan to fix it. Sometimes an MRI (Magnetic Resonance Imaging) is needed to make sure we are not dealing with a more serious condition, but this is not normally a first line of diagnoses.

Does physical therapy help shoulder impingement?

YES! Physical therapy can absolutely improve shoulder impingement. Physical therapy may utilize manual techniques, they may utilize specific shoulder stretches to improve range of motion, they will improve muscle imbalances by way of specific shoulder strengthening exercises, use functional training exercises, modalities such ass massage, ice pack, and sport specific home exercise programs to help fix your shoulder impingement fast so that you can continue living the active lifestyle you love.

How do you rehabilitate shoulder impingement?

The simple answer would be to attend formal physical therapy, but i’ll leave you with a few tips that may get your on the right track to healing your impingement syndrome.

Shoulder impingement can be tricky, so a correct diagnosis (ensuring you do not have a rotator cuff tear) and finding your limitations either in a lack strength in the rotator cuff muscles or a lack of range of motion (which could even occur at the thoracic spine) are all an important part of rehabilitation. Beginning your rehab with gentle joint movements, light isometric strengthening, maintaining good posture, therapeutic modalities, and reducing painful movements (maybe even using the opposite hand more) are going to be key to getting your shoulder inflammation under control early one. Once you have reduced your pain we can begin to increase the volume and intensity of your shoulder strengthening exercises (with or without a resistance band). We can also start to increase the ranges of motion in which you complete your shoulder strengthening exercises, which can help begin to get you back to your daily activities and sports. Lastly, It is important that once we have fixed your shoulder pain that we focus on keeping your shoulder pain away. We do this by consistently completing a regular routine of shoulder stretches as well as a regular shoulder strengthening routine and that consists of shoulder stabilization exercises (see exercises 8-11 below).

Physical Therapy Exercises for Shoulder Impingement:

1.Side-lying External Rotation

This exercise is an awesome rotator cuff strengthening exercise. Its not just in our opinion though, a study completed in 2004 by Reinold et. al showed that this particular exercise is best for contraction of the infraspinatus and teres minor (two muscles of the rotator cuff).

2. Scaption Raise

Just like above this is another great exercise for those dealing with shoulder impingement because it helps isolate another one of the rotator cuff muscles (supraspinatus) specifically. As the ladder was, this exercise was also specifically studied by Reinold et al. in 2007. A good note for this is that limiting the range of motion during this rotator cuff strengthening exercise is important to keep inflammation and pain low during exercise.

3. Shoulder Rows

The row exercise is a great global shoulder strengthening exercise, but is also a very functional exercise. We also really like this one because it can be loaded heavy without increasing pain in the shoulder joint (most of the time). Heaving loading of this can create stress through the muscles of the rotator cuff which will create an adaptation response which can help heal shoulder impingement syndrome.

4. Bilateral External Rotation

While we are on the trend of using specific exercises to target very specific muscles groups that play a larger role in shoulder health, this is another one of my favorites. This helps target the lower trapezius muscle which is important for proper movement of the scapula during activities that involve lifting overhead.

5. Serratus Anterior Punch

What the heck is a serrates anterior, right? Its a small, unheard of muscle that plays a LARGE role in proper mechanics of the shoulder joint. This is another exercise that can often be performed with little to no pain at all which makes it another ideal shoulder strengthening exercise that will keep inflammation low while building strength throughout the shoulder complex.

6. Prone Y Raise

The prone Y exercises is a good advanced shoulder strengthening exercise that helps target the lower trapezius muscle group. This shoulder muscle is particularly helpful in helping the shoulder blade move smoothly against the thorax (ribcage). It should be noted that full pain free range of motion is needed to begin this exercise. We would not suggest this for acute shoulder injuries. There is a variation of this exercise that is completed lying face down on the ground. I wouldn’t not suggest completing this because it is a end range only exercise. Follow the video see to the right for a correct, more efficient way of completing this shoulder girdle strengthening exercise.

7. Prone T Raise

Similar to the shoulder strengthening exercise above the Prone T is a great strengthener that is specific to the posterior deltoid muscle of the shoulder. Unlike the exercise above your do not necessarily need full shoulder range of motion, but this exercise should remain pain free.

8. 90-90 External Rotations

This is absolutely one of the best dynamic shoulder stability exercises for the shoulder. It is good for the average person dealing with shoulder impingement syndrome, but is even better for those overhead athletes (baseball players, volleyball players, swimmers, quarterbacks, etc.)

9. Rhythmic Stabilizations

This is a category of shoulder strengthening exercises that can be completed in just about any position of the shoulder joint. The goal of these is to improve stability of the shoulder joint by having the shoulder pain patient react to external forces applied by the clinician. The perturbations should be random and can vary in speed depending on how difficult we want to make the shoulder strengthening exercise.

10. Overhead walking with kettle bell

If you haven’t caught on by now, shoulder stabilization is the name of the game in regards to keeping shoulder impingement syndrome from coming back once we have gotten rid of it. The overhead kettle carry is an exercise that significantly challenges shoulder stability in over head positions. This positional shoulder stability can be very helpful for CrossFit athletes and olympic weight lifters who need stability in these positions very often and with a lot of excessive loading.

11. Kettle bell presses

This exercise is another fantastic way to utilize a kettle bell to create an unstable environment for the muscles of the shoulder joint. The other thing we love about this one is that it is more dynamic in nature and it also helps mimic a more functional everyday activities which the previous kettle bell exercise does not (unless you’re a very avid olympic weightlifter).