If you are experiencing shoulder pain in certain positions or during specific movements, particularly reaching out to the side or overhead, then you may be experiencing a condition called shoulder impingement syndrome.

These days it’s often called subacromial pain syndrome and refers to shoulder pain caused by compression of the muscles that surround the ball and socket of the shoulder joint, the rotator cuff, and the bursae that sits above it:

shoulder picture of the subacromial space

What to avoid and how to treat shoulder impingement

Shoulder impingement syndrome is not the kind of condition where a ‘no pain, no gain’ approach is helpful. Pushing through the pain won’t fix this condition and can actually make things much worse. So in the short term it’s important to modify or stop doing things which are painful whenever possible to relieve your symptoms. This often means avoiding activities where you have to reach over shoulder height or movements that are repeated over and over again.

Medication or strapping your shoulder with tape will help for pain relief. Your GP might also recommend a steroid injection.

The best exercises to gently tighten the rotator cuff muscles without causing pain are called isometrics. Isometric exercises involve tightening the shoulder muscles by pressing your arm or hand against something immovable to create muscle tension but without moving your arm.

Isometric ‘press and hold’ exercises for the rotator cuff muscles

Exercises for shoulder impingement

Stand side onto a wall. Press the back of your hand into the wall and build up the pressure until you are pushing firmly without provoking pain. Hold for 30 seconds. Press your hand into your tummy and hold for 30 seconds. Finally hold the back of your wrist with your good side and press outwards into your hand and hold for 30 seconds.

Repeat 4 times, every 2 hours.

Assessment of the underlying causes

There are lots of factors that can contribute to the development of shoulder impingement syndrome, so successful treatment is largely based on a comprehensive examination of the underlying causes.

A physiotherapist will complete a number of physical tests and may recommend hands on treatment in combination with an individualised programme of exercises to target underlying issues like weakness, poor movement patterns or a loss of flexibility.

Here are three of the exercises we often recommend in our Cambridge clinic:

Shoulder blade press ups on a wall:

Shoulder strengthening for stability to treat impingement

  • Stand with your hands on a wall
  • Press the heel of your hands into the wall (imagine you are pushing the wall away from you) and feel your shoulder blades slide apart around your ribcage
  • Relax and draw your shoulder blades back towards each other
  • Repeat 15 times, keeping your elbows straight throughout the exercise

Assisted arm lifts

Arm lift exercise to improvement movement if you have impingement

  • Hold a stick between both hands and use your good arm to assist your bad arm to lift out to the side. Only do as much as you need to with your good arm in order to complete the movement comfortably
  • Repeat 15 times slowly

Shoulder stretch

Shoulder stretch for impingement

  • Stand side onto a wall with your bad side
  • Reach across your chest and use your good arm to gently increase the stretch
  • Hold for 30 seconds and repeat 3-5 times

These exercises are recommended explicitly for shoulder impingement syndrome and not for other types of shoulder or neck pain. In fact, before starting any treatment a thorough examination to rule out any involvement of your neck (referred pain) and other shoulder conditions is strongly recommended, as treatment for these conditions may be different.

A physiotherapist will be able to advise you on the right approach and progress your exercises at the right time to restore full, pain free movement again.

Please don’t hesitate to get in touch if you have any questions at all,

The Physiofit Team.