Shoulder impingement occurs when the tendons of the rotator cuff are compressed between the bones of the shoulder during overhead movements. It is one of the most common causes of shoulder pain, affecting athletes, weightlifters, and anyone who performs repetitive overhead activities. Understanding the causes and knowing the right exercises can help you treat and prevent this condition.
For rotator cuff strengthening, see Rotator Cuff Exercises: Complete Guide. For upper body exercises that support shoulder health, see The Press, Part 1.
What Is Shoulder Impingement?
Shoulder impingement (also called subacromial impingement syndrome) happens when the supraspinatus tendon and the subacromial bursa become pinched in the space between the humeral head (top of the arm bone) and the acromion (part of the shoulder blade) during arm elevation. This compression causes inflammation, pain, and restricted movement over time.
Causes of Shoulder Impingement
1. Poor Posture
Rounded shoulders and forward head posture reduce the space in the subacromial region, making impingement more likely. Desk workers and anyone who spends long hours hunched over a computer are at elevated risk.
2. Muscle Imbalances
Weakness in the lower trapezius and rotator cuff muscles, combined with tightness in the pectorals and upper trapezius, creates the postural conditions that lead to impingement.
3. Overhead Repetitive Movements
Activities that require repeated overhead arm elevation (swimming, throwing, painting, overhead pressing) increase the risk of impingement. In weightlifting, excessive overhead pressing without adequate rotator cuff work is a common culprit.
4. Structural Abnormalities
Some people have a hooked acromion (a bony structure on the shoulder blade that is more curved than normal), which reduces the subacromial space and predisposes them to impingement.
5. Prior Shoulder Injury
Previous shoulder injuries, including rotator cuff tears, labral tears, or shoulder instability, can alter shoulder mechanics and lead to secondary impingement.
Symptoms of Shoulder Impingement
- Pain with overhead activities: Lifting your arm above shoulder height causes sharp or aching pain
- Pain at night: Especially when lying on the affected side
- Pain when reaching behind: Reaching into your back pocket or bra strap area causes discomfort
- Weakness in the arm: Difficulty lifting objects or maintaining overhead positions
- Catching or clicking: Sensation of catching or clicking in the shoulder during movement
- Reduced range of motion: Difficulty fully elevating the arm
Treatment for Shoulder Impingement
Phase 1: Reduce Inflammation
Acute impingement pain can be managed with rest, ice (15-20 minutes, several times daily), and anti-inflammatory measures. Avoid activities that cause pain, but do not completely immobilize the shoulder.
Phase 2: Restore Range of Motion
Once acute pain subsides, begin gentle range of motion exercises: pendulum swings, wall walks, and passive overhead stretches. The goal is to restore full shoulder mobility without aggravating the condition.
Phase 3: Strengthen the Rotator Cuff
This is the most important phase. The rotator cuff and scapular stabilizers must be strengthened to correct the underlying muscle imbalances. For a complete rotator cuff program, see Rotator Cuff Exercises: Complete Guide.
Phase 4: Return to Activity
Gradually reintroduce overhead activities, ensuring proper form and adequate rotator cuff strength. Add overhead pressing back into your program slowly, starting with light weights and high reps.
Exercises for Shoulder Impingement
External Rotation with Band
Stand with a resistance band at elbow height, elbow bent to 90 degrees and pinned to your side. Rotate your forearm away from your body against the band's resistance. Perform 3 sets of 15 reps. This strengthens the infraspinatus and teres minor, which stabilize the humeral head.
Internal Rotation with Band
Stand with a resistance band at elbow height on the opposite side. Elbow bent to 90 degrees and pinned to your side, rotate your forearm toward your body against the band's resistance. Perform 3 sets of 15 reps. This strengthens the subscapularis.
Scapular Retraction (Face Pulls)
Set a cable or band at face height. Pull the attachment toward your face while externally rotating your shoulders. Squeeze your shoulder blades together at the end. Perform 3 sets of 12-15 reps. This strengthens the lower trapezius and rear deltoids.
Prone Y-T-W Raises
Lie face down on an incline bench or the floor. Raise your arms into Y, T, and W positions with light weights or no weight. Perform 2 sets of 10 reps for each position. This strengthens the lower trapezius and rotator cuff simultaneously.
Wall Slides
Stand with your back against a wall, arms in a goalpost position. Slowly slide your arms up the wall while maintaining contact. Perform 3 sets of 10 reps. This improves overhead mobility and scapular control.
Pendulum Swings
Lean forward with one hand on a table. Let your affected arm hang freely and gently swing it in small circles. Perform 2 sets of 20 circles in each direction. This promotes gentle movement without loading the impinged structures.
Preventing Shoulder Impingement
Prevention is more effective than treatment:
- Balance pushing and pulling: For every pressing exercise, perform an equal volume of rowing. See Barbell Row.
- Strengthen the rotator cuff: Include rotator cuff exercises in every upper body workout. See Rotator Cuff Exercises.
- Maintain good posture: Keep your shoulders back and down, especially during desk work
- Warm up properly: Before overhead pressing, perform band pull-aparts and face pulls
- Progress gradually: Do not increase overhead pressing volume or intensity too quickly
When to See a Doctor
Consult a healthcare professional if:
- Pain persists for more than 2-3 weeks despite rest and exercises
- You experience significant weakness in the arm
- Pain wakes you from sleep regularly
- You cannot raise your arm above shoulder height
- You have acute trauma followed by severe pain
Shoulder impingement is highly treatable with the right approach. Address the underlying muscle imbalances, strengthen the rotator cuff, and maintain proper shoulder mechanics to resolve and prevent this common condition.
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