Overcoming Shoulder Impingement: Six Exercises For Fast Relief
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What is Shoulder Impingement
Shoulder impingement can cause persistent pain and discomfort, making it difficult to exercise and carry out simple everyday activities.
It occurs when the rotator cuff tendons or bursa are compressed between the bones in the shoulder. The condition is often caused by repetitive overhead activities, such as throwing a ball or lifting weights.
While some cases of shoulder impingement may require medical attention, there are several exercises you can do at home to help alleviate pain and discomfort.
In this article, I share six easy-to-follow exercises that can help relieve your shoulder impingement symptoms and improve your shoulder stability and mobility.
Shoulder impingement occurs when the subacromial bursa (a small fluid-filled sac located between the rotator cuff tendons and the acromion bone that acts as a cushion to reduce friction and help the tendons glide smoothly as you move your arm) and the supraspinatus tendon (one of the rotator cuff tendons) get trapped between the acromion (the tip of the shoulder blade) and the head of the humerus (the upper arm bone) as you raise the arm.
Courtesy of https://www.injurymap.com/diagnoses/rotator-cuff-syndrome>Shoulder pain
How Poor Posture Can Cause Shoulder Impingement
Poor posture can lead to shoulder impingement by causing misalignment and overuse of the muscles in the shoulder joint.
When you have poor posture, your shoulders may be rounded forward, causing the muscles in the front of the shoulder to become shortened and tight while the muscles in the back become lengthened and weak.
This muscular imbalance can result in the head of the humerus bone being pulled forward, compressing the soft tissues in the shoulder and causing impingement.
By improving your posture, you can help alleviate the stress on your shoulders and prevent impingement from occurring.
How Overuse Can Cause Shoulder Impingement
Shoulder impingement can be caused by overuse, particularly in activities requiring repetitive overhead motion, such as throwing a baseball, serving in tennis, or lifting weights.
Over time, these movements can cause irritation and inflammation of the tendons and muscles in the rotator cuff and result in shoulder impingement.
This can also be common in jobs that require overhead work, such as construction or painting. The repeated overhead motion causes the structures in the shoulder to compress against each other and eventually cause pain and discomfort.
Which Rotator Cuff Tendon is Commonly Affected in Shoulder Impingement?
By Young Lae Moon, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=23337523
The rotator cuff tendon commonly affected by shoulder impingement is the supraspinatus tendon. This tendon passes through the subacromial space, the narrow passageway between the acromion (a bony tip of the scapula) and the head of the humerus (upper arm bone).
When this space becomes narrowed or inflamed, it can compress the supraspinatus tendon and lead to impingement.
In some cases, other rotator cuff tendons, such as the infraspinatus or subscapularis, may also be affected.
Symptoms of Shoulder Impingement
The symptoms of shoulder impingement can vary but commonly include pain in the shoulder often described as a deep ache.
This pain may be located on the top of the shoulder, on the outer side of the arm, or the front of the shoulder.
The pain can also radiate down the arm. In some cases, there may be a weakness in the arm or shoulder, making it difficult to perform tasks that require strength, such as lifting weights or carrying heavy objects.
Additionally, there may be a clicking or popping sensation in the shoulder when moving the arm.
Some people may also experience swelling or tenderness to touch in the shoulder area.
Painful arc is a common symptom of shoulder impingement that occurs when you lift your arm. It is characterized by a sharp pain or discomfort in the shoulder when your arm is lifted between 60 and 120 degrees, commonly called the painful arc range. The painful arc symptom is often an early indicator of shoulder impingement and can progress to more severe pain and a limited range of motion if left untreated.
What Happens if Shoulder Impingement is Left Untreated
If shoulder impingement is left untreated, the condition may worsen and lead to more severe damage to the rotator cuff tendons, bursa, or other structures in the shoulder. This can result in chronic pain, weakness, and limited range of motion in the shoulder joint.
In some cases, a rotator cuff tear or other significant injury may occur, which may require surgical intervention to repair.
Getting Relief
The first step in managing shoulder impingement is to avoid activities or movements that cause stress to the shoulder.
Overuse or repetitive motions can exacerbate the condition and cause further damage. It is essential to identify the specific activities or positions that trigger pain and discomfort and avoid them as much as possible.
Some movements and exercises to avoid include
overhead pressing exercises
heavy lifting
throwing
repetitive activities that involve raising your arms above your head
exercises that require sudden, jerky movements or twisting motions of the shoulder
As with knee injuries and acute lower back pain, ice and electrical stimulation (E-stim) can help manage shoulder impingement.
Ice is a simple and inexpensive treatment that can be done at home.
Applying ice to the shoulder can help to numb the area, reduce swelling, and decrease inflammation. Ice can also help to slow down nerve impulses in the area, which can help to reduce pain.
Applying a cold pack can help reduce pain and inflammation caused by shoulder impingement
To use ice for shoulder impingement, place a cold pack or bag of ice (or bag of frozen peas!) on the affected area for 15-20 minutes at a time, several times a day. Be sure to wrap the ice in a towel or cloth to avoid direct contact with the skin, which can cause frostbite.
Electrical Stimulation (E-stim) such as TENS involves the use of a small electrical current to stimulate the nerves in the affected area.
This current can help to reduce pain and inflammation, and can also help to promote healing.
Electrical Stimulation such as Transcutaneous Nerve Electrical Stimulation (TENS) can block pain signals and stimulate the release of endorphins to help reduce shoulder pain
E-stim can be done using a small device that is placed on the skin over the affected area. The device delivers a mild electrical current to the nerves, which can help to block pain signals and stimulate the release of endorphins, the body's natural painkillers.
In some cases, you might have to take some over-the-counter anti-inflammatory medications, such as Ibuprofen or Naproxen, to help with the pain and reduce the inflammation.
Remember that while these medications are effective in reducing inflammation, they can also have side effects like stomach upset, heartburn, and ulcers. Taking these medications for a long time or in high doses can increase your risk of these side effects.
What is the best way to sleep with shoulder impingement?
Sleeping with shoulder impingement can be difficult and painful, but there are ways to minimize discomfort and support healing.
The best way to sleep with shoulder impingement is to avoid laying on the affected shoulder.
Instead, try sleeping on your back or the opposite side with a pillow or two supporting the affected arm. This position will help reduce pressure on the shoulder and prevent further irritation or inflammation.
Exercises for Shoulder Impingement
Now that you've effectively managed your acute pain using the techniques we discussed, it's time to start focusing on moving your shoulder and strengthening the muscles around it to prevent future flare-ups.
The following exercises are designed to alleviate the impingement by improving the stability and mobility of the joint, ultimately allowing you to reduce pain and regain the full range of motion and strength.
The Pendulums
The first exercise to alleviate shoulder impingement pain is the pendulum exercise.
This exercise helps improve the range of motion in the shoulder joint without placing excessive stress on the rotator cuff tendons.
This movement also helps to loosen the shoulder joint and reduce any swelling or inflammation that may be causing impingement.
PENDULUM FORWARD BACK AND IN CIRCLES
Courtesy of HEP2GO
Use your other arm for support
Place the leg opposite to the injured shoulder side forward
Bend at the waist
Allow your injured arm to hang freely
Move the body, allowing gravity gently swing the shoulder forward and backward, and then in circles
Your injured arm should be fully relaxed throughout the exercise
Shoulder Blade Squeezes (Scapular Retractions)
Shoulder blade squeezes help strengthen the upper back muscles, including the rhomboids and lower trapezius, which play an important role in stabilizing the shoulder blade. This exercise can also improve posture and reduce tension in the neck and shoulders.
The shoulder blade squeezes pull the humeral head back, thus lessening the impingement.
During the shoulder blade squeeze exercise, the shoulder blades are pulled back and down, which causes the humeral head to move posteriorly (backward) and inferiorly (downward).
This movement creates more space in the subacromial area, where the rotator cuff tendons and bursa lie.
As a result, there is less compression and impingement on the tendons, and pain is reduced.
Additionally, strengthening the muscles that control the shoulder blade helps to stabilize the shoulder joint, reducing the likelihood of further impingement.
SHOULDER BLADE SQUEEZES (SCAPULAR RETRACTIONS)
Courtesy of HEP2GO
To perform shoulder blade squeezes:
1. Sit or stand with your arms at your sides.
2. Squeeze your shoulder blades together and down your back.
3. Hold the squeeze for 5-10 seconds.
4. Release and repeat for 10-15 repetitions.
5. Keep your shoulders relaxed and avoid shrugging them up towards your ears.
This exercise can be done several times a day and is a great way to begin addressing shoulder impingement pain.
3. External rotation with a resistance band
This exercise helps strengthen the external rotator muscles of the rotator cuff, which can help improve shoulder mechanics and reduce impingement.
The external rotation motion also helps to stretch the internal rotator muscles, which tend to get tight in individuals with shoulder impingement.
SHOULDER EXTERNAL ROTATION WITH RESISTANCE BAND
Courtesy of HEP2GO
To perform this exercise, follow these steps:
Begin by tying a resistance band to a stationary object, such as a doorknob or a post.
Hold the other end of the band in your hand and stand with your side facing the anchor point.
Put a towel roll between your elbow and your side
Keep your elbow bent at a 90-degree angle and in firm contact with the towel.
Slowly rotate your forearm outward while keeping your elbow stationary. The band should provide resistance, but not so much that it causes pain.
Hold the position for a few seconds before returning to the starting position.
Repeat the exercise for 2-3 sets of 10-15 repetitions on each side.
Scaption
Scaption can be described as a combination of forward elevation and abduction (raising your arm up through the side). In scaption, the arm is raised in the scapular plane, which is at a 30 to 45-degree angle between the frontal (side-to-side) and sagittal (front-to-back) planes.
This movement pattern maximizes rotator cuff muscle recruitment in stabilizing the shoulder joint.
Scaption is a great exercise for strengthening the rotator cuff muscles, especially the supraspinatus, which is commonly involved in shoulder impingement.
Here's how to do it:
SCAPTION
Courtesy of HEP2GO
Stand with your feet shoulder-width apart and hold a light dumbbell in each hand.
Keep your palms facing down and your arms straight down by your sides.
Slowly raise your arms out to the sides and slightly forward, forming a "V" shape with your body.
Raise your arms until they are level with your shoulders, then slowly lower them back down.
Do 2-3 sets of 10-15 repetitions, and gradually increase the weight of the dumbbells as you get stronger.
Scaption works the muscles that help keep the shoulder blade stable and reduce the risk of impingement. It also strengthens the rotator cuff, improving overall shoulder function and reducing the likelihood of future injuries.
Common mistakes to avoid while doing scaption include:
• Raising your arms too high, which can lead to impingement
• Letting your arms drift behind your body, which puts unnecessary stress on your shoulder joints
• Using weights that are too heavy can cause strain and injury.
Wall Angels
"Wall angels" can help improve your shoulder blade and scapular movement, which can reduce impingement and help prevent future injuries. This exercise also helps strengthen your rotator cuff muscles and improves overall shoulder stability.
WALL ANGELS
Courtesy of HEP2GO
Step-by-step instructions:
1. Stand with your back against a wall, with your feet shoulder-width apart and about 6 inches from the wall.
2. Keep your shoulders, elbows, and wrists in contact with the wall.
3. Raise your arms over your head, keeping your elbows bent at 90 degrees.
4. Slowly move your arms up and down, keeping them in contact with the wall.
Common mistakes to avoid:
• Arching your back: Keep your lower back flat against the wall throughout the exercise.
• Overextending your arms: Keep your elbows bent at 90 degrees throughout the exercise.
• Letting your shoulders lift off the wall: Keep your shoulders, elbows, and wrists in contact with the wall throughout the exercise.
Side-lying Shoulder Horizontal Abduction
This exercise targets the supraspinatus muscle, one of the four rotator cuff muscles.
Benefits:
• Helps to strengthen the supraspinatus muscle, which can help to reduce impingement and pain.
• Improves shoulder stability.
SIDELYING HORIZONTAL ABDUCTION
Courtesy of HEP2GO
To perform this exercise:
Lay on your unaffected side
Hold a lightweight dumbbell in the hand of the injured side. If your shoulder is still weak or sore do the exercise without the weight.
Start with your hand at the head level and your palm facing you.
Lift your arm to the ceiling keeping your palm facing your head. Avoid reaching too far back.
Lower the weight to the initial position
Repeat 10-12 times
Common Mistakes:
• Pointing your thumb down
Conclusion
In this article, I have provided you with six easy-to-follow exercises that can help alleviate shoulder impingement pain and discomfort.
These exercises are pendulums, shoulder blade squeezes, side-lying external rotation, side-lying horizontal abduction, scaption, and “wall angels”.
By performing these exercises regularly and correctly, you can help improve your shoulder mobility, reduce pain, and prevent further impingement.
However, it's important to note that if your pain persists or worsens, it's essential to seek professional medical advice to rule out any underlying conditions.
I encourage you to try these exercises at home and incorporate them into your daily routine for shoulder impingement relief.
Remember to start slow and listen to your body, as pushing yourself too hard can cause more harm than good.
With time and patience, you can alleviate your shoulder impingement symptoms and improve your overall shoulder health.
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