5 Exercises for Shoulder Impingement
Key takeaways:
Shoulder impingement causes shoulder pain, especially when you lift your arm overhead.
This is an overuse injury, meaning those who perform repetitive overhead activities are most at risk.
Conservative treatment like rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and exercises will often treat this condition. Recommended exercises include rotator cuff and scapular strengthening, as well as stretches.
Table of contents
Shoulder impingement is one of the most common shoulder conditions, affecting up to 65% of those who have shoulder pain. It can affect a wide variety of people, from young athletes to older individuals who perform a lot of overhead movements.
The good news is that conservative treatment with exercise and activity modification is generally the best treatment approach. In fact, a systematic review found moderate evidence that surgery wasn’t more effective than exercise. Keep reading to learn more about shoulder impingement, and the stretching and strengthening exercises you need for a healthy shoulder.
What is shoulder impingement?
To understand how to improve shoulder impingement, it helps to first understand what causes this condition. You may have heard of the rotator cuff. This is a group of four tendons that attach to the head of your humerus (your upper arm bone). These tendons pass through a narrow space called the subacromial space.
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Normally, there’s enough space for the rotator cuff tendons and the fluid-filled sac called the bursa. But when these structures are compressed and irritated with arm movement, it causes impingement. You feel this as shoulder pain, especially when you move your arm overhead.
Anything that changes the way the shoulder moves within its limited space can cause irritation and pain. This can include:
Repetitive overhead motions or overuse
Weakness in the rotator cuff muscles
Weakness in the muscles that support the shoulder blade (scapula)
An abnormal shape of the bone at the top of the space (the acromion)
What are the best exercises for shoulder impingement?
Exercises consist of rotator cuff and scapula strengthening, as well as stretches to maintain range of motion. These exercises also prevent muscle imbalances that can contribute to impingement.
1. Resistance band rows
Exercises that strengthen the muscles controlling your scapula are important in treating shoulder impingement. For this banded row exercise, you’ll need a resistance band, or you can use the cable pulley machine at the gym.
Step 1: Secure a resistance band around a stable support, such as by closing it in a door or looping it around a beam. Leave two ends loose to hold.
Step 2: Stand with your feet shoulder-width apart, facing the band. Grab one end of the band with each hand.
Step 3: Hold your arms straight out in front of you, parallel to the floor. Back up if needed to remove any slack in the band.
Step 4: Pull back on the band, moving your elbows straight behind you in a rowing motion. Squeeze your shoulder blades together at the end of the movement.
Step 5: Relax and return to the starting position.
Step 6: Repeat 2-3 sets of 12-15 repetitions.
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2. Internal rotation
This banded internal rotation exercise strengthens one of your rotator cuff muscles. Again, you can use a resistance band or the cable pulley machine at your gym.
Step 1: Secure one end of a resistance band in the door or tie it around a stable support at waist height.
Step 2: Turn 90 degrees so you’re no longer facing the band. Stand with your affected arm closest to the band.
Step 3: Hold onto the band and bend your elbow to 90 degrees. Keep your elbow tucked at your side throughout the movement.
Step 4: With your palm facing up, pull the band in as your hand rotates toward your stomach.
Step 5: Return to the starting position.
Step 6. Continue for 2-3 sets of 10-12 repetitions on each arm.
3. External rotation
This banded external rotation exercise strengthens different rotator cuff muscles. You’ll need a resistance band or the cable pulley machine at the gym.
Step 1: Secure one end of a resistance band in a door or tie it around a stable support at waist height.
Step 2: Stand with your affected arm away from the band.
Step 3: Grab the band with your affected side and bend your elbow to 90 degrees. Keep your elbow tucked at your side throughout the movement.
Step 4: With your palm facing up, pull the band out as your hand rotates away from your body.
Step 5: Return to the starting position.
Step 6. Continue for 2-3 sets of 10-12 repetitions on each arm.
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4. Shoulder extension
This shoulder extension exercise works your rotator cuff muscles, as well as the muscles that support your scapula.
Step 1: Secure a resistance band around a stable support, such as closing it in a door or looping it around a beam. Leave two ends loose for you to hold.
Step 2: Keeping your elbows straight, grab the band with each hand. Your hands should start slightly in front of your body.
Step 3: Pull your arms straight back against the resistance of the band, squeezing your shoulder blades together at the end of the motion.
Step 4: Return to the starting position.
Step 5: Repeat 2-3 sets of 10-12 repetitions.
5. Wall slide
This wall slide exercise helps maintain the range of motion in your shoulder. This is important to avoid stiffness, which can happen if you don’t move your shoulder due to pain.
Step 1: Stand in front of a wall and place a washcloth or small towel in the hand of your affected arm.
Step 2: Start at waist height and slowly slide your hand up the wall as your arm extends over your head.
Step 3: Only go as far as you can comfortably. You may feel a stretch, but stop if you feel sharp pain. As your mobility improves, you can work your way up.
Step 4: Hold at the top for 10-15 seconds.
Step 5: Repeat 2-5 times.
What’s the fastest way to treat shoulder impingement?
Experts recommend starting with conservative (nonsurgical) treatment. The good news is that most people will start seeing improvement within 2 weeks. So, your hard work will be worth it. Treatment includes:
Rest/activity modification: For the first 1 to 2 weeks, avoid activities that make your pain worse, especially repetitive overhead activities.
Avoid immobilization: Don’t stop moving your arm altogether. Don’t use a sling, as this can make your arm stiff. Perform gentle movements within your pain-free range, and do the exercises above as tolerated.
Ice or heat therapy: Ice and heat can help with symptoms. Use an ice pack for 15-20 minutes on your sore shoulder twice a day for the first few weeks. This will help decrease pain and inflammation. After that, you can switch to a heat pack to help increase circulation and mobility.
OTC pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen can help with pain and inflammation. Acetaminophen may also help with pain. Limit these medications to a week or two at a time.
Physical therapy: A physical therapist can help determine the best exercises and guide you through them. They may also add other modalities, like manual therapy, if needed.
Acupuncture: This may be a safe and effective way to decrease pain, but research on shoulder impingement is limited.
Corticosteroid injection: When combined with exercises, a subacromial injection can help improve pain and mobility. But this might not be for everyone because of the risk of side effects.
The American Academy of Orthopedic Surgeons (AAOS) recommends doing exercises 2 to 3 times a week for 4 to 6 weeks, even as your symptoms improve. It can be frustrating at first, especially if your dominant arm is affected. But it’s important to rebuild strength in your shoulder and let the irritation settle. Stop if you feel any pain and talk to your primary care provider or physical therapist.
If conservative treatment doesn’t help, you may need surgery. A procedure called subacromial decompression can help widen the space, so the rotator cuff tendons have more space to move. But research has questioned the effectiveness of surgery. Talk to your primary care provider to see if it’s right for you.
How do you prevent shoulder impingement?
Shoulder impingement is an overuse injury that happens gradually. There are things you can do to prevent this injury from occurring:
Warmup and cooldown: Warm up your muscles before a sport or activity. Spend 5-10 minutes gently using the muscles that will be active. You can also add some dynamic stretches, like arm circles. Afterward, take some time to cooldown and stretch.
Practice proper exercise form: If you have pain with any exercises or are unsure how to do something correctly, stop and talk to a trainer. Proper form can help prevent injury.
Stretch and strengthen shoulder muscles: Follow a regular shoulder strengthening and stretching program. The exercises mentioned above are a good start.
Maintain proper posture: A slouched posture can put your shoulder joint in a position that makes it more prone to injury, especially with overhead activities. Consider simple exercises to improve your posture as a part of your routine.
Cross-train: You can cross-train by incorporating different activities and exercises to avoid repetition and overuse.
Make time for rest and recovery: Include a couple rest days per week into your training or exercise routine.
The bottom line
Shoulder impingement is a common condition, especially for those who do overhead activities. It causes pain in the front of the shoulder, especially when lifting your arm overhead. Conservative treatment is often all that’s needed. This includes rest, NSAIDs, and exercises for rotator cuff and scapular strengthening and stretching. Most people will fully recover without surgery.
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References
Alizadehkhaiyat, O., et al. (2017). Postural alterations in patients with subacromial impingement syndrome. International Journal of Sports Physical Therapy.
Consigliere, P., et al. (2018). Subacromial impingement syndrome: management challenges. Orthopedic Research and Reviews.
Creech, J. A., et al. (2023). Shoulder impingement syndrome. StatPearls.
Escamilla, R., et al. (2014). Optimal management of shoulder impingement syndrome. Open Access Journal of Sports Medicine.
Garrido, J. C. R., et al. (2016). Acupuncture treatment of shoulder impingement syndrome: A randomized controlled trial. Complementary Therapies in Medicine.
Hershfield, N. (2023). Exercises for shoulder impingement, from a PT. Hospital for Special Surgery.
Horowitz, E. H., et al. (2023). Shoulder impingement syndrome. Physical Medicine and Rehabilitation Clinics of North America.
Lähdeoja, T., et al. (2020). Subacromial decompression surgery for adults with shoulder pain: A systematic review with meta-analysis. British Journal of Sports Medicine.
Lavoie-Gagne, O., et al. (2022). Physical therapy combined with subacromial cortisone injection is a first-line treatment whereas acromioplasty with physical therapy is best if nonoperative interventions fail for the management of subacromial impingement: A systematic review and network meta-analysis. Arthroscopy.
Ma, C. B. (2023). Rotator cuff problems. MedlinePlus.
Ravichandran, H., et al. (2020). Effect of scapular stabilization exercise program in patients with subacromial impingement syndrome: A systematic review. Journal of Exercise Rehabilitation.
Saltychev, M., et al. (2015). Conservative treatment or surgery for shoulder impingement: systematic review and meta-analysis. Disability and Rehabilitation.
Tangtiphaiboontana, J., et al. (2024). Shoulder impingement/rotator cuff tendinitis. OrthoInfo: The American Academy of Orthopeadic Surgeons.
