Physical Therapy for Shoulder Impingement

Shoulder impingement is a very common problem to occur in the shoulder.  Generally, you feel pain when lifting overhead and reaching behind your back.  You will have pain on the top of the shoulder and sometimes in the front of the shoulder.

Impingement is a pinching of a muscle in the shoulder.   There is a muscle that runs in between the arm bone (humorous) and the top of the shoulder (acromion).  There is a gap between the arm bone and the acromion that allows this muscle to go through.  When the muscle is healthy there is no pain as the arm goes overhead but when the muscle is not healthy you wind up with pain.

Every time you lift your arm that tunnel narrows.  When your muscle becomes inflamed, for one reason or another, like over use or a strain, that muscle doesn’t move through the tunnel without it causing pain.  When you lift your arm overhead you get that pinching feeling as that muscle is literally being pinched in between the two bones and you get pain.

This pain that you get when you reach overhead that starts as impingement can also lead to a rotator cuff tear.  The more times that muscle gets pinched, the bones can cause a tear in the muscle, the rotator cuff.

How does the gap start to close and how does the muscle become inflamed? 

There are several things that lead to the muscle become inflamed.  Poor posture is the biggest thing that causes the muscle inflammation.  When you slump forward and your shoulders come forward, like when you sit at a computer or you are checking your phone, you will close the gap where that tendon sits, and you will start to irritate it because it becomes squeezed.  The longer you sit in that position the more that tendon becomes squeezed and thus begins the process that causes impingement.

The longer it is left untreated the longer that muscle, instead of being squeezed, starts to be almost sawed causing a tear in the muscle.  The longer there is squeezing the more rubbing and sawing that occurs and thus begins the process of the rotator cuff tear.  That is why most rotator cuff tears are caused, not by traumatic accidents but by people opening a door or turning a knob.

While we will go over some exercises that can be done at home leaving this untreated can lead to a very serious situation, a rotator cuff tear.

The first exercise is to correct your posture.  You cannot get rid of your shoulder impingement if you do not correct your posture.  The first exercise is to roll your shoulders up, back and drop them down.  Do not squeeze them back but simply drop them down.  You will need to do this quite often during the day in order to retrain your body on where your shoulders need to be positioned.

The next exercise to be done for impingement is a range of motion exercise.  You want to do this standing in front of a mirror.

To begin, roll your shoulders up, back and drop them down.  Then watching yourself in the mirror, slowly raise your arm overhead.  As you raise your shoulder make sure you are pushing your shoulder down.  You want to keep this range of motion pain free.  You do not want to shrug your shoulder or have your shoulders rolled forward so that the muscle continues to be pinched.  You want to do this several times throughout the day, in sets of 30 in order to retrain the shoulder on how to lift the arm.

Then at the end of the day you want to ice your shoulder to help with the inflammation.  15 minutes at the end of the day to help with the tendon inflammation.  But more importantly you want to get this treated professionally before it becomes more than just an inflammation.

If you have shoulder pain and live in Montgomery or Bucks County PA, call our office for a free consultation at 215-997-9898 to have a Doctor of Physical Therapy look at your shoulder.


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