How to Prevent Shoulder Impingement Pain

Your Personal PT, Rachel Tavel, is a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS), so she knows how to get your body back on track when it’s out of line. In this weekly series, she gives you tips on how to feel better, get stronger, and train smarter.

Whether you’re a swimmer, a thrower, a CrossFit junkie, or just a guy trying to get through the workday, shoulder pain can pop up. Exercise can definitely help, but doing the wrong set of reps might lead you down a path of even more pain rather than relief—so you’re going to want to be careful about your next move.

If you’re experiencing pain with overhead or cross-body movements, or simply when sleeping on your side or putting on a coat, you might be experiencing symptoms associated with shoulder impingement.

The shoulder joint is one of the more complex joints in the human body. When the mechanics are off, pain can be a result. Formed by the humerus, scapula, and clavicle, multiple muscles help move these bones in a rhythm to allow for pain-free functional use of the arm. Unfortunately due to poor posture and muscle weakness, sometimes this sequence of movement is off and one or more important structures can become inflamed.

By definition, shoulder impingement is when one of the rotator cuff tendons or the shoulder bursa become impinged or compressed within the joint, leading to inflammation and pain. Usually pain develops after repetitive overhead movements such as overhead presses, lat pulldowns, or even with movements like triceps dips, but it can also be felt with repeated loading of the joint in other ways. Pain may develop at the top of the shoulder and can radiate down the side and/or back of the shoulder as well.

If symptoms are not addressed, this can lead to fraying or damage to the supraspinatus muscle tendon, bursitis (inflammation of the busa), or more chronic pain.

Fight back by strengthening the appropriate muscles and working on body mechanics and form so that you prevent future pain and maintain the integrity of the rotator cuff musculature.

Your Move:

Rotator cuff strengthening: Strengthen your rotator cuff with resisted external and internal rotation. Try 2 to 3 sets of 15 to start using either a resistance band against an anchor or lying on your side with a 2 to 5 pound dumbbell.

Strengthen scapular retractors with resisted rows. Your middle traps and rhomboids will help you keep your shoulders back and prevent them from rolling forward, positioning that can easily contribute to shoulder impingement pain with overhead movements.

Open up pecs with a pec stretch on the foam roller or in a doorway. If you spend a lot of time at a desk or on a computer or cell phone, you may have tight pecs. Because of their attachment points, the pecs can pull your shoulder blades forward and down, compressing the joint space that is needed for proper shoulder elevation. Make sure your pecs don’t get in your way by spending 30 to 60 seconds daily either stretching the pecs while lying on your back with arms out on a foam roller or using a doorway (arms up against the sides of the wall).

Prone scapular retraction with depression. One of the best exercises you can do to improve posture is to lie on your stomach, squeeze your shoulder blades back and slide the shoulder blades down towards your feet so that it feels like your fingers are reaching for your toes. Hold this position for 5 seconds before the next rep. Try 2 sets of 10 reps daily.

Shoulder protraction. The serratus anterior is an important muscle for healthy shoulder mobility and scapular stability. Try performing protraction in quadruped or a full plank. With hands on the ground and a neutral spine position, slowly push your palms into the floor allowing the shoulder blades to separate from each other. Hold 10 seconds before slowly coming out of that position into the retracted shoulder blade position. Repeat this 10 times with a 10 second hold if possible. Begin in quadruped and progress to a full plank position.

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