Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, you will find out everything you need to know about shoulder impingement and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Shoulder Impingement Exercises
In this article, you will discover the most effective shoulder impingement exercises designed to reduce pain, restore mobility, and prevent recurrence. These strategies are supported by research and clinical case studies, ensuring evidence-based results.
Shoulder impingement syndrome is one of the most frequent causes of shoulder pain, often leading to reduced range of motion and decline in function. Many patients describe worsening pain when lying on the affected shoulder or when lifting the arm overhead (Koester et al., 2005t)).
What Is Shoulder Impingement?
Shoulder impingement (also called swimmer’s shoulder or rotator cuff tendinitis) occurs when the tendons of the rotator cuff and surrounding structures become compressed, inflamed, or irritated. This condition often develops due to repetitive use, aging, or injury.
The rotator cuff is made up of four key muscles — supraspinatus, infraspinatus, teres minor, and subscapularis — that stabilize the shoulder joint. A small fluid-filled sac called the bursa also cushions movement. When swelling occurs, these structures press against each other, causing pain and limited mobility. The acromion, which forms the top outer edge of the shoulder blade, can reduce the space available for the rotator cuff tendons. Treatments and exercises often aim to create more space under the acromion to relieve impingement symptoms.
Causes of Shoulder Impingement
The most common causes of shoulder impingement include:
- Muscle imbalances and weakness in rotator cuff or upper back muscles (McClure et al., 2004).
- Poor posture (rounded shoulders, forward head).
- Overuse from repetitive activities such as tennis, swimming, throwing, or lifting, which can make symptoms worse.
- Bone spurs that reduce the subacromial space (Khan et al., 2013).
- Frozen shoulder, arthritis, or trauma-related injury (such as a fall or car accident). Certain causes, especially trauma, can make pain and reduced range of motion worse.
Rotator Cuff Muscles and Injury
The rotator cuff muscles are essential for the smooth and stable movement of the shoulder joint. This group of four muscles—supraspinatus, infraspinatus, teres minor, and subscapularis—work together to keep the top of the arm bone firmly within the shallow socket of the shoulder. The rotator cuff tendons connect these muscles to the bones, allowing for a wide range of motion and providing crucial support during daily activities.
Injury to the rotator cuff is a common cause of shoulder pain and can lead to shoulder impingement syndrome. These injuries often result from repetitive overhead movements, sudden trauma, or gradual wear and tear as we age. When the rotator cuff tendons become irritated or inflamed, they can get pinched between the bones of the shoulder, leading to impingement syndrome. Typical symptoms include pain, especially when lifting the arm, weakness, and reduced mobility. If not addressed, rotator cuff injuries can progress to more serious problems such as tendon tears or bursitis, where the fluid-filled sacs (bursa) in the shoulder become inflamed. This can result in chronic pain, ongoing inflammation, and further limitation of movement in the shoulder joint.
Diagnosing Shoulder Impingement Syndrome
Accurately diagnosing shoulder impingement syndrome is the first step toward effective treatment and pain relief. A physical therapist or doctor will begin by discussing your medical history, including any previous injuries, repetitive activities, or trauma that could contribute to your shoulder pain. During the physical examination, they will assess your shoulder joint for range of motion, strength, and areas of tenderness or discomfort. Special tests may be performed to pinpoint the source of the impingement and evaluate how the shoulder moves.
In some cases, imaging tests such as X-rays or MRI scans are recommended to get a clearer picture of the shoulder structures and rule out other possible causes of pain, such as fractures or arthritis. Occasionally, a diagnostic injection may be used to temporarily numb the area and help determine whether the pain is coming from the shoulder joint itself or the surrounding tissues. This thorough approach ensures that shoulder impingement syndrome is correctly identified, allowing for a targeted and effective treatment plan.
Shoulder Impingement Exercises at Home
Exercise is the cornerstone of rehabilitation. Exercising regularly is essential to improve strength and mobility, while monitoring pain levels to ensure safe progress. Each exercise strengthens specific muscles that support the shoulder, enhancing stability and function. The following evidence-based movements can strengthen the rotator cuff, improve posture, and reduce pain. Gradually increasing pressure or resistance during exercises helps build strength without causing pain.
External Rotation (Side-Lying)
Lie on the non-painful side, with your elbow bent at 90 degrees and resting on your side. For better arm positioning, place a rolled up towel under your elbow. Keep your elbows close to your body throughout the movement. As you perform the exercise, ensure your forearms move smoothly and stay aligned with your body. Slowly rotate your shoulder to lift your hand towards the ceiling. Start with light resistance (2kg dumbbell or resistance band). Perform 2–3 sets of 10–20 reps daily.
Internal Rotation
Start in the correct position to ensure safety and effectiveness. Lie on the affected side with your elbow bent at 90 degrees, keeping your elbow tucked at your side and your forearm parallel to the floor. Maintain this position as you rotate your arm so your hand moves toward your abdomen. Perform 2–3 sets of 10–20 reps with light resistance. This exercise can also be performed standing with a resistance band, making sure to keep your elbows at your side and your forearms in the proper position throughout the movement.
External Rotation with Abduction
Start in the correct position by standing with your arm abducted at 90 degrees (parallel to the floor), keeping your elbow bent at a right angle and your forearm aligned with the floor. Make sure your elbow stays in line with your shoulder throughout the movement. Rotate your hand upwards towards the ceiling, maintaining the position of your elbows and forearms. Perform with a resistance band or light dumbbell. Repeat 10–20 reps for 2–3 sets.
Shoulder Adduction (Scapular Retraction)
Stand tall and gently draw your shoulders back, squeezing your shoulder blades together. Keep your elbows bent at about 90 degrees and close to your sides to maintain proper position. Hold briefly, then release. Make sure to maintain the correct position of your elbows and shoulder blades throughout the exercise. Perform 3 sets of 10–30 repetitions, gradually adding light resistance.
Stretching for Shoulder Impingement
Chest Stretch (Doorway Stretch)
Begin in the starting position by standing upright facing a doorway. Place your arms at chest level on the doorway, making sure your elbows are slightly bent and aligned with your sides. Lean forward until you feel a stretch across your chest. Hold for 15–20 seconds and repeat 3 times.
Thoracic Extension (Foam Roller)
Lie on your back with your knees bent and feet flat on the floor, ensuring a stable position. Place a foam roller under your shoulder blades. With your hands supporting your head, keep your knees in the bent position as you gently extend your upper back over the roller. Hold for 5–10 seconds, repeat 5–10 times.
Creating a Personalized Exercise Plan
A personalized exercise plan is key to successfully managing shoulder impingement syndrome and returning to normal activities. Working with a physical therapist ensures that your plan is tailored to your unique needs, taking into account your current level of pain, mobility, and any specific goals you may have. The plan will typically include a mix of simple exercises designed to relieve pain, improve flexibility, and strengthen the rotator cuff muscles without putting unnecessary strain on the shoulder.
Starting with gentle movements and light weights helps prevent further injury and allows your body to adapt gradually. As your strength and mobility improve, your physical therapist will guide you in progressing to more challenging exercises, always avoiding repetitive overhead movements that could worsen impingement syndrome. Consistency is important—regularly performing your exercises can reduce pain, restore function, and help you get back to your normal activities within a few weeks. Remember to listen to your body and stop any exercise that causes new pain or discomfort. With the right support and a well-structured plan, most people can overcome shoulder impingement and regain confidence in their shoulder movement.
Treatments for Shoulder Impingement
Treatment aims to reduce pain, restore range of motion, and prevent recurrence. Approaches include:
- Rest and activity modification.
- Ice therapy (20 minutes, 2–3 times daily) using an ice pack or cold pack to reduce inflammation and soothe pain.
- NSAIDs (ibuprofen, naproxen) as recommended by a doctor.
- Physical therapy to restore movement and strength. Self-massage techniques, such as using a massage ball on the biceps muscle, can help relieve muscle tension and pain.
- Corticosteroid injections for severe inflammation.
- Surgery (in advanced or persistent cases).
If symptoms get worse or do not improve with these treatments, further evaluation may be needed.
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat Shoulder Impingements.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to repair the damage and help Shoulder Impingements.
As prolotherapy is helping to treat the root cause of Shoulder Impingements, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Frequently Asked Questions
How do I fix my shoulder impingement?
A combination of rest, ice, physical therapy, and strengthening exercises is usually effective. Severe cases may require injections or surgery.
How long does shoulder impingement take to heal?
Most cases improve within 3–6 months, though severe impingement can take up to a year.
Can I lift weights with shoulder impingement?
Avoid overhead lifting until symptoms improve. Focus on rehabilitation exercises first.
Is heat good for shoulder impingement?
Heat can relax sore muscles but won’t reduce inflammation. Use ice during acute pain.
Can sleeping on my side cause shoulder impingement?
Yes, lying on the painful side can compress the rotator cuff tendons, worsening symptoms.
Can I ride a bike with shoulder impingement?
Cycling may aggravate pain due to posture and weight-bearing through the arms. Short sessions may be tolerated with caution.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the treatment of shoulder pain, with patients travelling from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms and providing effective treatment options. He trained in Prolotherapy and Prolozone Therapy in the USA with the American Academy of Ozonotherapy and pursued further qualifications at the Royal Society of Medicine, Charing Cross Hospital, Keele University, and Heidelberg University.
He has treated many elite-level athletes, including Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
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References
- Koester M, George M, Kuhn J. Shoulder impingement syndrome. Am J Med. 2005;118(5):452-455.
- McClure P, Bialker J, Neff N, Williams G, Karduna A. Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome. Phys Ther. 2004;84(9):832-848.
- Khan Y, Nagy M, Malal J, Waseem M. The painful shoulder: Shoulder impingement syndrome. Open Orthop J. 2013;7(1):347-351.
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.