Shoulder impingement syndrome is a common cause of shoulder pain. It occurs when there is impingement of tendons or bursa in the shoulder from bones of the shoulder. The tendons that are prone to impingement include the biceps tendon and the rotator cuff tendon. Overhead activity of the shoulder, especially repeated activity, is a risk factor for shoulder impingement syndrome. Examples include painting, lifting, swimming, kayaking, tennis, weightlifting, and throwing sports. Other risk factors include bone and joint abnormalities.
Musculoskeletal factors that lead to impingement syndrome include, weakness in the rotator cuff and muscles of the upper back, shoulder joint and/or muscle tightness, poor body mechanics (how a person controls his or her body when moving), an abrupt increase in an exercise routine, and age-related body changes.
Impingement syndrome results when excessive, abnormal forces are applied across the tendon or bursa, including tension (pulling of the muscle and tendon), compression (pushing or pinching), or shearing (rubbing). When the tendons or bursa are subjected to repetitive stresses, they can become irritated, swollen, and painful.
Some movements that can be painful with impingement syndrome include sharp pain in the front of your shoulder when you reach overhead, tenderness to touch at the front of your shoulder, pain when throwing a ball, and difficulty with daily activities, such as reaching behind your back to tuck in your shirt, pulling off a shirt overhead, or putting dishes away in an overhead cabinet.
Other symptoms include pain that may radiate toward the neck or down the front of the arm, dull, achy pain at the front of the shoulder, especially following activity Weakness may also be felt around the shoulder joint. This is usually experienced when lifting or carrying objects or reaching overhead. A sensation of irritation in the front of the shoulder at end ranges of movement may also be felt.
In regards to overcoming impingement syndrome, the first common-sense recommendation is to take a short break from aggravating activity. This allows irritation to settle down and the tendon and/or bursa to heal. If pain persists, hands-on therapy to alleviate pain can be effective. Self-myofascial release to key regions (lats, shoulder blade) can also be effective and performed with a lacrosse ball or foam roller. As the pain subsides, you should address the root causes of impingement syndrome.
In many cases, impingement syndrome is coupled with poor mobility of the lats and the t-spine. This can be combined with the weakness of the rotator cuff and the lat muscles. In addition, if there are imbalances at other regions of the body, posture and movement can be affected. The best way to know what is contributing to pain is to have an assessment performed.
Improvements can be made quickly if the right regions are targeted. If weakness is found, learning how to activate muscles that are not firing well is important. Some beginner exercises include the side-lying shoulder external rotation and "I's, T's, and Y's." Examples can be found in our video library. Once muscles engage better, the next step is learning how to generate tension during compound pushing (e.g. push-up) and pulling (e.g. ring row) movements. A plan of progression that includes increased resistance and advanced movements will help achieve lasting results.
When addressed with a specialized physical therapy program, impingement syndrome is a condition that should resolve. However, ignoring pain and practicing poor shoulder mechanics may result in a more serious shoulder problem. If you have concerns about impingement syndrome, the physical therapists at Movement Solutions would be glad to be a resource for you.
We offer a free guide on relieving shoulder pain that can give you further insight into shoulder problems and help kickstart your recovery. If you’re considering physical therapy but have questions, we are available for a free 15-minute phone consultation so you can have your questions answered before booking an appointment.
If you want help, you can request a shoulder consultation. During this appointment, you can ask questions, obtain clarity, and foster confidence that you can overcome impingement syndrome. If you feel like we're a good fit to work together, we're happy to discuss the next steps.
If you’re in pain and unsure about what your next step should be, call us at (864) 558-7346 and ask how we can help.