Imagine reaching up to grab something from a high shelf, only to feel a sharp, stabbing pain in your shoulder and trying to throw a ball but stopping mid-motion because of sudden discomfort and lack of mobility. These scenarios illustrate the difficulties faced by those suffering from shoulder impingement. But what causes this condition, and what is the best exercise for shoulder impingement options to help alleviate the pain?
Shoulder impingement, also known as subacromial impingement, rotator cuff tendinitis, or swimmer’s shoulder, occurs when there is excessive friction in the subacromial space of the shoulder joint. This is the narrow passage between the humeral head (top of the upper arm bone) and the acromion (a bone that forms the highest point of the shoulder). When tissues such as the rotator cuff tendons or subacromial bursa become irritated or inflamed, arm movement leads to compression and pain.
Common Causes and Contributing Factors
There are several potential causes and risk factors leading to shoulder impingement:
Poor Posture
Slumped forward shoulders can reduce the subacromial space, allowing impingement to occur more quickly. Rounded shoulders brought on by prolonged sitting at a computer or looking down frequently at a phone are increasingly common posture problems.
Overuse
Repetitive overhead motions during sports, work duties, or everyday activities can create excessive shoulder wear. Examples include swimming, tennis, baseball pitching, painting, stocking shelves, or assembling parts above shoulder level.
Underlying Structural Issues
Variations in the shape of the acromion bone, calcification of the rotator cuff tendons, or bony growths on the humerus called bone spurs can all contribute to impingement over time.
Muscle Imbalances
Weaknesses, tightness, or impaired coordination among the rotator cuff and scapular stabilizer muscles can lead to shoulder instability and impingement.
Previous Injury
Prior shoulder dislocations, fractures, tears, or surgeries can alter shoulder mechanics and increase susceptibility to impingement.
As you can see, shoulder impingement tends to be a gradual process occurring over time rather than a single event. Understanding common causes makes it easier to pinpoint your predisposing factors.
Why Exercises Are Crucial for Healing
Conservative treatment focused on exercise is the best initial approach for managing shoulder impingement. Here’s why it’s so important:
- Restores Strength and Flexibility: Counteracts muscle imbalances and instabilities underlying impingement. This relieves compression in the shoulder joint.
- Encourages Proper Mechanics: Trains the neuromuscular system to move the shoulder joint through safer ranges of motion. This prevents excessive friction of tissues.
- Enhances Blood Flow: Improves circulation of oxygen and nutrients to aid healing of irritated tendons and bursa.
- Prevents Atrophy: Maintains muscle mass to support the shoulder joint and prevent additional pain from disuse.
- Avoids Surgery: Up to 90% of patients respond favorably to exercise therapy, making invasive procedures unnecessary for most.
But not just any shoulder exercises will provide relief for an impingement diagnosis. The proper selection is critical.
The 5 Best Exercises for Shoulder Impingement
When choosing exercises for shoulder impingement, the goal is to open up space within the shoulder joint while restoring proper movement patterns. This simultaneously alleviates pain in the short term while correcting the underlying causes to prevent re-injury.
The five movements below check all these boxes and more, making them the top exercises for shoulder impingement.
- Shoulder Retractions
How to Do It: Stand or sit tall with arms relaxed at your sides. Initiate the movement by pinching shoulder blades together while keeping arms relaxed. Draw shoulders straight back without elevating. Hold for 5 seconds, then relax back to the starting position. Repeat for 10-15 reps.
Why It Helps: This directly counteracts slumped forward shoulder posture, contributing to impingement. Retracting the shoulders opens space within the shoulder joint rather than allowing compression. It also strengthens the mid-upper back muscles, preventing future postural imbalances.
- Wall Slides
How to Do It: Stand with your back gently touching a wall. The feet should be about 6 inches away. Keep neck neutral and abs engaged. Slowly slide arms overhead along the wall until a slight stretch is felt (no pain). Hold for 5-10 seconds, then slide back down. Repeat 10-15 times.
Why It Helps: Wall slides open the subacromial space by retracting your shoulder blades while safely elevating your arms in an aligned position. This allows impinged tissues room to heal while encouraging optimal shoulder mechanics through the elevation movement pattern.
- External Rotation
How to Do It: Hold the involved arm close to the body with the elbow bent 90 degrees. Gently rotate the arm outward, keeping the upper arm stationary. Stop when you feel stretched without pain. Hold for 5 seconds, then relax back to the starting position. Aim for three sets of 10-15 reps. You can use a light resistance band to help activate muscles once you can.
Why It Helps: The infraspinatus and teres minor of the rotator cuff externally rotate the shoulder joint. Strengthening these muscles helps balance internal rotators that tend to be overused, a common factor in shoulder impingement.
- Scapular Retraction and Depression
How to Do It: Lie face down on the floor with the involved arm hanging straight down off the edge of a table/bed. Initiate movement by drawing the shoulder blade toward the opposite side of the spine while lowering it down away from the ear. Aim for three sets of 10-15 reps. I can hold a light dumbbell for the extra challenge once able.
Why It Helps: Works the middle, lower, and serratus anterior traps to improve scapular stability. When these muscles are weak or inactive, the shoulder blade tends to elevate and wing outward. This crowd structures in the shoulder joint, making impingement more likely.
- Thoracic Spine Rotation Stretch
How to Do It: Sit or stand with your arms crossed before your chest. Without moving arms, rotate the upper body toward one side and then the other within a comfortable range. Apply gentle pressure with the opposite arm to increase stretch. Hold each side for 20-30 seconds.
Why It Helps: Loosening up the upper back and thoracic spine allows for better shoulder blade mobility. Since the shoulder blade glides along the rib cage, improving thoracic mobility alleviates compression and friction within the shoulder joint.
Program Design Considerations
To experience significant and lasting relief from shoulder impingement symptoms, exercises must be performed consistently for several weeks to maximize results. Most patients attend physical therapy 1-2 times per week while performing home exercises for another 3-5 days.
Here are some key programming factors to consider:
- Begin with meager resistance and focus on technique, only progressing weight when able to maintain good form
- Start with higher repetitions (15-20) initially; build toward heavier weight for 8-12 reps
- Include focused stretching for tight pecs, lats, and posterior shoulder
- Modify exercises as needed to find pain-free ranges of motion
- Allow 48-72 hours between training sessions for proper rest and recovery
- Ice or use heat after workouts to help manage inflammation
- Use caution with exercises like push-ups, dips, overhead presses, and straight-arm pull-downs
- Avoid pounding exercises like running until shoulder function improves
With a well-designed regimen focused on the right moves, you can reduce and resolve shoulder pain while restoring strength for daily life.
Frequently Asked Questions
1. Are exercises safe if I have arthritis or bone spurs in my shoulder?
Yes, the appropriate exercises can still provide significant benefits even with arthritis or bone spurs. Focus on range of motion and gentle strengthening movements that do not compress the shoulder joint. Avoid heavy weights or excessive repetitions.
2. How long until I start seeing results from the shoulder impingement exercises?
Most patients notice some pain relief within 2-4 weeks of starting a focused exercise program. As you continue, flexibility and strength will improve for better function. Maximum benefits often occur around the 12-week mark with consistent effort.
3. Can I do shoulder impingement exercises every day?
You will get the best results by allowing rest days between shoulder training sessions. Work up to exercising the shoulder about five days per week, with at least one full rest day for tissues to adapt and recover properly. This prevents overtraining and re-irritation.
4. Is it okay to do cardio machines like the elliptical with shoulder impingement?
Cardio equipment is generally acceptable as long as shoulder motion is relatively comfortable. Start at slower paces, focusing on good form and proper posture. Stop immediately if shoulder pain worsens. Low-impact options like the elliptical, stationary bike, or pool exercises are best in the early stages.
5. Will I eventually need surgery for my shoulder impingement?
The good news is that successful outcomes from a focused exercise regimen mean most patients—up to 90%–won’t require shoulder surgery later. In rare cases that remain symptomatic for many months despite appropriate conservative care, surgical options like debridement may be considered.
The Takeaway
Dealing with stiff, painful shoulders from impingement is frustrating. But knowledge about what’s causing your shoulder troubles and specifics on the most helpful exercise for shoulder impingement and superb techniques make it much easier to experience relief.
Just stick with the protocol and allow enough rest between training days. Incorporating weighted jump ropes into your fitness regimen not only elevates your cardiovascular health but also, through consistent practice, realigns posture, regains mobility, supports the joint capsule, and activates the right muscles, setting you on a path to comfortably move and use your shoulders again in just a few weeks.
