Do you have pain that goes from the front of your shoulder down the side of your arm?
Even if the pain is minor, if it’s constantly there or it flares up at night, you could be suffering from a preventable and treatable condition.
Shoulder impingement is a fairly common source of shoulder pain, but few people know what to do about it.
In this post, we’ll talk about how you can tell you have a shoulder impingement and what the cause of it may be. We’ll also give you the exercises and stretches you need to fix it so that you can eliminate pain and have better movement and strength in your shoulders.
What is Shoulder Impingement?
Shoulder impingement is when the 4 shoulder-stabilizing tendons that make up your rotator cuff become tight and inflamed, causing them to “catch” onto your upper shoulder bone.
It’s one of the most common causes of shoulder pain, but it’s also one of the easiest to fix.
Shoulder impingement can be reversed with myofascial release in the shoulder joint, which helps lubricate the rotator cuff and keep it separated from the shoulder bone.
Note that shoulder impingement can progress to a point where it becomes extremely painful especially as you get older. In this case, we would recommend seeing a physician before attempting to fix this condition on your own.
How to Test for Shoulder Impingement
Feeling how your shoulders respond to certain positions allows you to test for shoulder impingement on your own.
Try these positions. They activate your rotator cuff in a way that’s painful if you have shoulder impingement. If you feel pain from these, it’s a sign you do have impingement.
- Shoulder flexion with internal rotation – Place one hand on your opposing shoulder, then raise your elbow directly upwards.
- Shoulder abduction with internal rotation – Stretch one arm out straight in front of you and rotate it inward from your shoulder so that your thumb points downwards. Then use your other hand to pull the outstretched arm across your body.
- Overhead reach – Extend your arms straight above your head. Note whether it’s difficult or painful, or if you feel a “catching” sensation. These are signs of impingement.
Be sure to test both shoulders so that you know whether you have it in one or both of them. Watch the video above to learn how to test for shoulder impingement.
If you’re still not sure after doing these tests, consult with a physician, who can help determine the source of your shoulder pain.
Further Symptoms of Shoulder Impingement
In addition to feeling pain in the positions we just talked about, you’ll also experience some of these symptoms from shoulder impingement:
- Shoulder aches and pains
- Increased pain at night
- Shoulder joint stiffness
- A catching sensation when raising your arm(s) overhead
- Weakness in the arm(s)
- Reduced range of arm motion, especially overhead
Causes of Shoulder Impingement
Shoulder impingement is ultimately caused by a tight, inflamed rotator cuff. Because the rotator cuff is surrounded by bone, when it swells the pressure within it increases, causing compression and reduced circulation.
Without adequate blood flow, the tendons that make up the rotator cuff begin to fray like a rope.
There are different activities that irritate your rotator cuff over time.
When you don’t treat inflamed, tight rotator cuffs with massage therapy after the irritation occurs, the condition can quickly build up and worsen, leading to pain and putting you at risk of a rotator cuff tear.
These are some of the activities that can aggravate the rotator cuff and lead to shoulder impingement:
If your job requires you to do a lot of heavy lifting, such as from painting, moving boxes or doing construction work, your shoulders can develop tightness from the strain and overuse they endure.
Without regular stretching and releasing of your shoulders, this can lead to shoulder impingement.
As your muscles and tendons knot over time, the necessary space between your rotator cuff and shoulder bone closes.
Playing sports that involve repetitive, forceful arm motions, such as overhead throws and racquet swings, puts you at risk of developing a shoulder impingement from the overuse and swelling of the rotator cuff.
Swimmers, tennis players, football players and baseball or softball pitchers are among athletes at the highest risk.
Throwing a ball forcefully can cause microtrauma in your shoulder tissues and lead to tendonitis. This swelling is what makes the tendons “catch” onto the shoulder bone, causing pain.
Internally Rotated Arms aka “Gorilla Arms”
“Gorilla arms” are when your shoulders become rounded and are rotated inward so that your arms are also internally rotated, causing your palms to face toward you instead of laying against your sides.
This shoulder position closes the gap between your rotator cuff and upper shoulder bone, making it easy for impingement to happen.
Upper Body Muscle Imbalance
Besides repetitive and forceful use irritating the rotator cuff, muscle imbalance can also stress it.
Strength imbalance is both a cause and a result of shoulder impingement.
The more the tightness develops, the greater the imbalance becomes, because the functional anatomy of your shoulder has changed, which affects the muscles you recruit when using your arms.
When researchers looked at patients with shoulder impingements using electromyography (EMG), they saw an overuse of the upper trapezius and a lack of use in the lower trapezius and serratus anterior (the muscles at the sides of your ribs under each shoulder).
Overuse of the upper trapezius causes tightness that aggravates your shoulders and prevents them from relaxing downward.
Meanwhile, weak lower trapezius and serratus anterior muscles fail to hold the scapula (shoulder blades) in place against your back. As a result, your shoulders turn inwards and reduce the space between your rotator cuff and shoulder bone, causing them to “catch” easily .
Shoulder Muscle Weakness
Weak shoulders are also a cause and a result of shoulder impingement.
Weakness in the muscles in and around your rotator cuff and shoulder blade can cause your shoulder bone to move abnormally when you’re lifting a heavy object or throwing a ball forcefully.
These muscles are in charge of stabilizing the shoulder joint. Without strong muscle tissue in the joint, there’s more pressure of contact between the rotator cuff and shoulder bone.
Corrective Exercises and Stretches to Fix Your Shoulder Impingement
Seeing a physical therapist, chiropractor, physician or other professional is ideal when you have a condition like shoulder impingement, but in most cases, it can be healed at home by doing the right exercises.
Therapeutic exercises that correct muscle imbalances and release tight, inflamed muscles, tendons and fascia heal and restore normal function in your shoulders.
To fix shoulder impingement the goal is to correct the muscle imbalances in a three-step process of release, stretching and strengthening.
- Start with myofascial release techniques for your shoulders, which breaks up tightness, promotes tissue healing and should give you some pain relief.
- Then, do strength training exercises that target your lower trapezius and serratus anterior to strengthen the weak muscles. The strengthening of these muscles will help pull the shoulder into the right alignment.
- Finally, stretch and release your upper trapezius to help the muscle lengthen out and allow your shoulders to achieve proper alignment.
By doing these things, you’re working toward restoring a neutral, correct posture in your upper body.
Issues like inward-turned shoulders and a rounding of the upper back contribute to the muscle imbalances seen in people with shoulder impingement.
With regular practice, you’ll start to see your chest lift, your shoulder blades rest down along your back, your shoulders relax downwards away from your ears, and your head move back into alignment.
In other words, you should begin to see an improvement in your overall posture which has many benefits.
1. Release Techniques for Shoulder Impingement
Myofascial release breaks up tension in the fascia – the thin layer of connective tissue around muscles that provide lubrication and prevent them from catching onto bone.
Impinged shoulders undoubtedly have tight, blood-starved fascia, and the first step in healing them is through myofascial release with the appropriate myofascial release tool.
Myofascial release not only increases circulation, but also lowers inflammation and helps re-lengthen tight, knotted muscles.
A lacrosse ball or a tennis ball can be used in place of a massage ball, but massage balls are designed with the perfect density for myofascial release, and some of them contain bumps that allow you to dig deeper into small trigger points.
Using your ball, here are the myofascial release exercises you want to do for shoulder impingement:
Upper Trapezius Release
Tension, tightness and knots in the upper traps is quite common because of the way most people sit, with a slight “hunch” forward in the upper back.
When your upper traps are excessively tight, your shoulders creep up toward your ears and it can be hard for them to relax into their normal position.
With some myofascial release for the traps, you can help get your shoulders into a more neutral position where the rotator cuffs aren’t crashing into the bones.
Sitting in a chair, use one hand to roll the ball (applying pressure) over the area between your opposite shoulder and neck. Use the ball to feel around for spots that are painful or hard, and concentrate there. Or you can use a wall as shown in the video above.
If you have a trigger point massage stick such as the Thera Cane, this is also a great way to release tight spots in the traps. Watch the video above to learn how to release the traps using this method.
Pec Minor Release
The pectoralis minor is near the armpit region on either side of your chest where your shoulder meets your chest.
When these muscles are chronically tight from carrying heavy things or even from keeping your arms in front of you at a computer desk every day, they need to release.
In a contracted position, they’re pulling your shoulders forwards and inwards and they’re causing weakness in their opposing muscle groups, which is your serratus anterior–responsible for keeping your shoulder blades down along your back.
Releasing your pectoralis minor helps lift your posture so that your chest and shoulders can open and lengthen.
Place your massage ball on a wall in front of you. Lean in so that your pec minor is against the ball, and use the counterpressure of the wall to roll along the length of your pec minor.
As your pec minor loosens up over time with practice, you can try doing it on the floor with your stomach facing down and the ball directly under your pec minor. This way, you can use your body weight to apply a greater amount of pressure.
Once again you can also use a Thera Cane to release this muscle.
2. Stretches for Impinged Shoulders
Stretching helps the tissues in your shoulders heal from impingement by lowering inflammation, improving circulation and lengthening tight muscles.
The main stretches you want to do are for your pec minors and the fronts of your shoulders, which together make up the worst area of tightness in shoulder impingement.
Pec Minor Stretch
Stretch your pec minor on either side standing at an open door. Align your palms and forearms on each side of the door frame, so that your arms bend around 90 degrees at your elbows.
Step one foot in front of you and bend into that knee as you push your chest forward, feeling your pec minors open up. After this stretch, you should feel looser in your shoulders.
Stretch the front of your shoulders with the help of a chair. Standing in front of a chair, squat all the way to the ground with your palms behind you on the edge of the chair, your elbows bent 90 degrees.
If you’ve ever done chair dips to strengthen your triceps, that’s the position you’re going for. Squeeze your shoulder blades together and feel the stretch at the front of your shoulders.
Upper Trapezius Stretch
Stretching the upper traps will also help create some length between the head and the shoulder which will allow your shoulder to drop into a more optimal position.
The video above shows how to effectively stretch the upper traps.
3. Strengthening Exercises for Shoulder Impingement
Strengthening exercises are designed to fix the weak muscles that cause shoulder impingement and help pull your shoulders back into proper alignment.
In this section, we are going to work on the lower traps and the serratus anterior.
Lower Trapezius Exercises
Your lower trapezius is designed to support your upper body to prevent the neck and shoulder strain many people experience.
You can strengthen it with back exercises like chin-ups and high pulley cable rows.
– Chin Ups
- Grasp a pull up bar or assisted pull-up machine with your palms facing you, positioned a little closer together than shoulder-width.
- Hanging from the bar with your knees bent 90-degrees, pull yourself up until your chin is over the bar. Hold for 1 or 2 seconds.
- Slowly release back to your starting position and repeat for more reps.
– High Pulley Cable Rows
- Raise the pulleys to the highest height on the machine.
- Sit in front of the pulley machine on a chair, bench, stability ball or squat down low and grasp the handles.
- Sitting/standing up straight with your chest lifted and abs engaged, pull the handles in towards you with a rowing motion as you squeeze your shoulder blades together. Focus on using your back muscles to pull instead of your arms.
- Slowly retract the cables back to your starting position, allowing your shoulder blades to expand.
– Prone Cobra
The prone cobra is also a great exercise to help strengthen your back. Watch the video above to learn how to do this move effectively.
Serratus Anterior Exercise
Strong serratus anterior muscles help prevent scapular winging, as they work together with your rhomboids to keep your shoulder blades in place.
By keeping your shoulder blades flat against your back, they prevent your shoulders from rounding forward, where they cause shoulder tightness and a “hunched” upper back.
Wall Scapular Push Up
- Stand at arms length in front of a wall with your palms flat against the wall at shoulder height. Lift your chest and keep your spine in a straight line with your neck, tucking in your chin slightly.
- Protract, or spread apart, your shoulder blades so that your body moves just slightly away from the wall and your rib cage expands. Hold for 1 or 2 seconds.
- Contract your serratus anterior on the sides of your rib cage to retract your shoulder blades and bring your shoulder blades as close together as possible in an isolated movement.
- Repeat and complete 10 to 20 reps.
This exercise can also be performed on the floor like a regular pushup shown in the video above.
Preventing and Long-Term Care for Shoulder Impingement
To prevent shoulder impingement from developing again once you’ve fixed it, first get clear on the habits that first caused it.
- If it’s caused by activities at your job or it’s from the sport you play, be sure to do the aforementioned myofascial release, stretching and strengthening exercises regularly to counter the repetitive irritation to your rotator cuff.
- You can also switch to an ergonomic chair for better support or a standing desk, to help take the strain off your upper trapezius if you have to sit for long periods.
- Using certain massage tools on a daily basis can help you keep your upper trapezius muscles relaxed which should help with shoulder impingement. Such tools to consider are a neck and shoulder massager or a trigger point back stick.
- When you workout, avoid doing chest dips and chest flys, which tighten your pectoralis minor. Inflammation or irritation in this muscle group from strength training can cause shoulder impingement to flare up. You should focus on exercises aimed at strengthening your back.
- You should also focus on correcting your overall posture, particularly in the upper body. If you have shoulder impingement you most likely have rounded shoulders as well as forward head posture. Make it a priority to fix these issues.
Shoulder impingement is something you can’t ignore. In most cases, it doesn’t go away on its own.
With time and consistency, you can heal a shoulder impingement with therapeutic exercises involving self-massage therapy, stretching and strength training that corrects muscle imbalance.
When you have an injury like a shoulder impingement, you want to be very careful to avoid worsening it or incurring other injuries when doing exercises to fix it.
If you’re new to myofascial release or you’re not sure whether you’re doing the stretching and strengthening exercises correctly, it helps to see a professional for guidance.
The exercises mentioned here won’t be a full fix in some cases, so consult with a doctor to get the best treatment steps for you.