Shoulder impingement exercises
In this article you will find out about all the most effective shoulder impingement exercises to both reduce pain and prevent it from reoccurring.
Shoulder impingement syndrome is one of the most frequently occurring causes of shoulder pain leading to loss of range of motion ad decline in function. People with shoulder impingement often describe that the pain gets worse when they lie on the painful shoulder or when they reach their arms overhead(1)
Regular activities like combing your hair, taking a shower, or reaching up into a cupboard can hurt. People may also notice a general loss of strength.
What Is Shoulder Impingement?
Shoulder impingement is also known as shoulder impingement syndrome, swimmer’s shoulder, and rotator cuff tendinitis.
It causes shoulder swelling which makes this condition painful. This swelling can be caused by the overuse of the shoulder. Getting older and getting hurt may also aggravate the situation.
The shoulder is the region where the shoulder blade and upper arm bone, collar bone, and shoulder blade all come together.
There are four major muscles called rotator cuffs that wrap around the shoulder joint to protect the shoulder bones. These muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis. The rotator cuff holds the top of the upper arm in the shoulder socket.
Additionally, a bursa is a ”fluid-filled sac” that acts as a cushion between the bones and keeps the bones from rubbing against the socket. When an individual moves his/ her shoulder, the bursa allows the tendons to move freely, stopping them from sticking together and rubbing.
Impingement happens when inflammation makes the bones, muscles, or tendons press against each other or into the bursa.
Symptoms of shoulder impingement pain include shoulder stiffness, difficulty in moving the arm past shoulder height, and throbbing pain in the shoulder. This pain sensation may be similar to a pain in the tooth rather than the tearing of the muscle as a result of injury.
What Are The Causes Of Shoulder Impingement
Muscle imbalances, weakness, and tightness in the shoulder muscles can all lead to abnormal shoulder movement patterns(2). Additionally, poor posture, overuse, and doing the same things over and over again, like lifting, racquet sports, throwing, swimming, and golfing can cause shoulder problems. A severe shoulder injury, acromion bone abnormalities, and a frozen shoulder can also cause shoulder impingement.
Another common cause of shoulder pain caused by shoulder impingement is bone spurs. These bone spurs limit the sub acromial space around the rotator cuff, causing the rotator cuff to press on the acromion bone(3). In the case of bone spurs, a doctor will recommend an x-ray to make an accurate diagnosis of shoulder impingement syndrome.
Shoulder Impingement Exercises at Home
Strength training
Strengthening exercises are designed to strengthen the rotator cuff muscles, which are responsible for stabilizing the shoulder joint. There is also a focus on the upper back muscles that maintain posture, for example, Serratus Anterior and Rhomboids.
Always ensure that strengthening exercises do not cause pain. Immediately cease if there is any pain.
For shoulder joint strengthening, the following rotator cuff exercises can be performed daily:
External rotation lying
The patient lies on the floor with the affected arm on top. The upper arm should rest on the side, with the elbow bent and the hand pointing in the direction of the floor.
Gently ”rotate the shoulder so that the hand moves as high” as possible towards the ceiling. Now, return slowly to the initial position. Start with a light weight, approximately 2 kg. Repeat this exercise ten to twenty times. Try to perform these exercises with the help of a resistance band while standing.
Internal rotation position
Place the affected arm on the bottom while Lying on your side and position the forearm on the floor. Rotate the shoulder such that the forearm slides toward the abdomen and the hand points in an upward direction.
Slowly return the weight to the starting position. Begin with a lightweight, perhaps 2 to 3 kg. Start with ten to twenty repetitions. This workout must be practiced every day. This activity can also be performed with a resistance band while standing.
External rotational with abduction
The exercises indicated above can be advanced by doing them in an abducted position once weight and repetition progressions have been completed with ease:
With these types of shoulder impingement exercises the participant stands with their arm parallel to the ground and abducted to a 90-degree angle. The elbow may be supported by a bench or chair if it’s more practical (in a seated position).
Additionally, the elbow should be flexed to 90 degrees. Rotate the shoulder such that the hand points towards the ceiling, using the elbow as a fixed point. Come back slowly to the initial position.
Begin with a 2- to 3-kilogram dumbbell, a resistance band, or a cable pulley machine/. Repeat this exercise ten to twenty times.
In order to maintain good shoulder biomechanics, strengthening the shoulder girdle muscles is essential in any shoulder rehabilitation. The shoulder girdle comprises the collar bone( (clavicle) and the shoulder blade (scapular) The exercises below are intended to strengthen the shoulder girdle.
Shoulder Adduction
With these type of shoulder impingement exercises the participant tries to draw the shoulder back while keeping the head and arm straight. When performing this exercise, only the shoulder should be in motion.
Aim to increase exercise intensity gradually (at first without weight) from three sets of repetitions to three sets of thirty repetitions. Once three sets of thirty repetitions have been completed without negative effects, the weight can be increased.
Shoulder impingement exercises that involve stretching
Chest stretch
The doorway stretch will help you relax your shoulders and chest. Place your hands and elbows parallel to a doorframe. Step into the door gradually until you start to feel a stretch. Before going back to the starting position, maintain this end position for 15 to 20 seconds. Repeat this chest and shoulder stretch three times.
Thoracic Extension
According to research, people with shoulder impingement who add a thoracic extension into their treatment plans experienced better outcomes than people who don’t. Therefore, adding range before loading is always a smart idea.
Methods include: With these types of shoulder impingement exercises consider using a foam roll or a yoga mat that has been rolled up. Lay on your back with your knees flexed and your feet flat on the floor. Place the foam roller directly below your shoulder blades.
Your thoracic spine should be extended over the foam roll while you place your hands behind your head and complete the “J-loop.” Hold this position for 5 to 10 seconds.
Prolotherapy
Some structures have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.
Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is needed to heal them and provide pain relief.
As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.
Frequently asked questions
How Do I Fix My Shoulder Impingement?
Shoulder impingement treatment: Reducing your pain and regaining shoulder function are the main objectives of treatment for shoulder impingement syndrome. Impingement syndrome can be treated by applying ice, rest, ”over-the-counter anti-inflammatory medications”, physical therapy, pain relievers, and steroid injections.
Physical therapy is the most important part of the management of shoulder impingement syndrome. You can learn to perform physical therapy exercises at home after one or more visits to the physiotherapist. You’ll learn stretches to increase your arm movements. You can also start doing strengthening exercises to strengthen your rotator cuff muscles
Apply ice to the shoulder for 20 minutes. (Frozen corn or peas in a bag also works great.)
If you are in pain, you can consult your orthopedic doctor. He/she may prescribe you anti-inflammatory drugs such as Ibuprofen or naproxen as needed to ease discomfort. A cortisone injection into the bursa below the acromion or a stronger prescription-grade anti-inflammatory drug may be prescribed for more acute pain relief.
Avoid tasks that require you to reach behind your back. Usually, these movements exacerbate shoulders with impingement. Stop doing these tasks until your pain subsides, according to the medical advice given by a healthcare doctor or physical therapist. Maintain a good posture to prevent stress on the rotator cuff muscles.
In severe cases, surgical decompression will be performed to increase space for the rotator cuff muscles.
How long does a shoulder impingement take to heal?
Most cases will heal in 3 to 6 months, but more serious ones can take up to a year.
Can I lift weights with shoulder impingement?
After receiving a diagnosis of shoulder impingement, you must stop lifting weights overhead for a brief period to allow the tendons in your shoulder to heal. You can then begin a program of physical therapy to regain shoulder mobility.
Is heat good for shoulder impingement?
Heat may relieve sore muscles, but it will not diminish inflammation. Take a hot shower or take a warm bath. Do this for 15-minutes. Do not apply heat if the pain persists. Additionally, heat should not be used in acute injuries.
Can sleeping on your side cause shoulder impingement?
When lying on one’s side, the rotator cuff tendons may become compressed between the scapula and humerus. This can ad to rotator cuff friction, compression, and other disorders such as rotator cuff tear, tendinitis, and bursitis.
Can I ride a bike with shoulder impingement?
No, you cannot ride a bike with shoulder impingement. Riding with shoulder impingement further stretches the muscles around the shoulder joint and can result in pain. However, if biking is necessary, ride a bike for a very small duration.
References
- Koester M, George M, Kuhn J. Shoulder impingement syndrome. Am J Med. 2005;118(5):452-455. doi:10.1016/j.amjmed.2005.01.040,
- McClure P, Bialker J, Neff N, Williams G, Karduna A. Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. Phys Ther. 2004;84(9):832-848. doi:10.1093/ptj/84.9.832
- Khan Y, Nagy M, Malal J, Waseem M. The painful shoulder: Shoulder impingement syndrome. Open Orthop J. 2013;7(1):347-351. doi:10.2174/1874325001307010347