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Shoulder impingement is a common cause of shoulder pain, often associated with repetitive movements that irritate or compress the rotator cuff tendons.
Although shoulder impingement can develop at any age, people who frequently lift their arms overhead or perform weight-bearing activities may be at greater risk.
Over time, these repetitive movements, especially when combined with poor form, can irritate the tendons and soft tissue beneath the acromion, a bony projection at the top of the shoulder.
Shoulder impingement may go unnoticed for years until an intense, sharp pain is felt. At this stage, your doctor may evaluate your shoulder and recommend physical therapy to manage pain, improve posture and increase range of motion.
What Is Shoulder Impingement?
Shoulder impingement can develop when repetitive movements irritate or compress the rotator cuff tendons and surrounding soft tissue. This causes the tendons and bursa to swell until trapped between the humerus, scapula and clavicle. Due to the area affected, the condition is also called subacromial impingement syndrome.
Weight-bearing activities can also contribute to shoulder impingement. Even lifting light weights may place additional strain on the joint, particularly without a proper warm-up.
People who may be at greater risk include:
- Young athletes without an adequate warmup routine
- Weightlifters who increase their loads too quickly
- Baseball pitchers
- Volleyball players
- Swimmers
- Tennis players
- Golfers
- Manual laborers, including construction, house painting, window washing, drywall installation and warehouse work
Other factors that may contribute to shoulder impingement include:
- A fall that compresses the shoulder joint
- Bone abnormalities that narrow the subacromial area
- Osteoarthritis
- Muscle weakness
- Thickening of the bursa or ligaments
- Tight soft tissue
Regardless of the cause, symptoms include a combination of:
- Restricted side and overhead motion
- Pain when attempting to lift overhead, stretch the arm or throw an object
- Pain while sleeping on your side
Ignoring persistent shoulder pain may allow symptoms to worsen. Continued irritation can contribute to conditions such as bursitis or tendonitis and, in some cases, rotator cuff damage.
How Can Physical Therapy Help?
Physical therapy is often recommended before more invasive treatments are considered. Depending on your condition, your treatment plan may combine targeted exercises, hands-on therapy and education to improve movement and manage pain.
What Happens During a Physical Therapy Evaluation?
Your physical therapist will assess your shoulder mobility, strength and movement patterns, along with any available imaging results.
Tests to detect imbalances and weaknesses may include:
- Reaching overhead
- Assessing and comparing strength levels
- Asking where you feel the most pain
- A manual examination of the shoulder joint
A physical therapist may also ask questions about your lifestyle and the motions you regularly perform. Be prepared to discuss:
- Pain level, frequency and location
- Efforts to reduce your pain
- Any injuries to the area
- Actions and activities posing difficulty
- Job responsibilities
- Athletic training
- Hobbies
- Other related symptoms
What Exercises Help with Shoulder Impingement?
Your physical therapist will develop an exercise regimen with the goal of strengthening the shoulder blade muscles, improving joint mobility and posture, and optimizing form and mechanics.
You’ll begin practicing exercises during your physical therapy sessions before continuing them at home. Over time, these exercises can help address muscle weakness, improve posture and support healthier shoulder movement.
- Range-of-motion exercises to open up the joint, restore its natural mechanics, and better prepare the area for the demands of athletic training or your job.
- Strength and conditioning to build up your core and adjacent muscle groups that contribute to poor posture and imbalances.
- Functional training to help you learn the proper form and mechanics for common movements, preparing you to avoid future injuries.
What Other Physical Therapy Treatments Can Help?
Other therapies work to fight inflammation and make you more aware of your body, including:
- Manual Therapy: Your physical therapist uses hands-on techniques to improve shoulder mobility and reduce muscle tension.
- Education: To help injury-proof your job, training and lifestyle, you’ll learn to maximize your warmups, understand your limits, and better assess your form to reduce damage to the joint.
- Pain Management: Passive treatments like massage or applying ice can help control swelling and improve joint movement.
Frequently Asked Questions About Shoulder Impingement
- Can Physical Therapy Help Shoulder Impingement Without Surgery?
Yes. Through targeted exercises, manual therapy and movement training, physical therapists help reduce pain, improve shoulder mobility and strengthen the muscles supporting the joint. Many patients can manage their shoulder impingement symptoms without surgery.
- How Long Does Physical Therapy Take for Shoulder Impingement?
Recovery time depends on the severity of your symptoms, how long you’ve experienced pain and your treatment goals. Some patients notice improvements within a few weeks, while others may need several months of physical therapy. Your therapist will monitor your progress and adjust your treatment plan as needed.
- What Activities Should You Avoid with Shoulder Impingement?
Activities that repeatedly aggravate your shoulder, particularly overhead lifting, throwing or heavy weightlifting, may need to be temporarily modified. However, avoiding all shoulder movement isn’t usually recommended. Your physical therapist can help you identify which activities are safe and how to gradually return to your normal routine.
- Can Shoulder Impingement Heal on Its Own?
Mild shoulder impingement symptoms may improve with activity modifications and time. However, persistent pain or limited mobility may require treatment. Physical therapy can help address contributing factors, such as muscle weakness, restricted movement and repetitive strain, while reducing the risk of recurring symptoms.
- Is It Safe to Exercise with Shoulder Impingement?
In many cases, yes. The right exercises can help improve shoulder strength, flexibility and movement without aggravating symptoms. A physical therapist can recommend appropriate exercises based on your condition and guide you through a gradual progression as your shoulder improves.
Where Can You Find Physical Therapy for Shoulder Impingement?
At Integrated Rehabilitation Services, our physical therapists work with your care team to help restore shoulder strength, improve mobility and support a safe return to work or sports. Schedule today!