Injury of the Week # 6: Shoulder Impingement Syndrome

Shoulder Impingement Syndrome

What is it?

Shoulder impingement syndrome is when the rotator cuff tendons and/or bursa (a fluid filled sac) gets pinched under the boney structures of the shoulder (the acromion) with certain ranges of motion. This can limit the range of motion and can feel like a pinching sensation

When do you notice the pain?

You will notice the pain when trying to do overhead movements, where these structures will get pinched.

Where does it hurt?

It will hurt around the top of the shoulder.

How does it happen?

Commonly it stems from poor posture and muscle instability. The rotator cuff tendons are intended to help center the humeral head in place, so when these muscles are weak they can’t do its job.

When there is misalignment of the humeral head, the rotator cuff tendons can experience friction during movement, which can lead to inflammation.

The inflammation in turn leads to swelling, which reduces the space available in the joint.

As a result, the rotator cuff tendons can get pinched during movement and can limit the range of motion in the shoulder.

How can I help it go away?

Therapeutic exercises and stretches! We want to help stretch the muscles that are tight and strengthen the muscles that are weak.

Stretch of the Week for Shoulder Impingement Syndrome

Pendulum exercise

Here you can use a can of soup or a light weight.  Keep your arm heavy as you sway the body so the arm can move in circles. Try 20 circles one way and 20 circles the other way.

This is a great exercise to help open up the shoulder joint prior to exercise! It is also a great pain-reducing technique!

Prehab for Shoulder Impingement Syndrome

Alphabet on Wall

This is a great proprioceptive exercise.

What is proprioception?

Proprioception is the ability to know where our body is in space, otherwise known as joint position sense. Our shoulder in particular can achieve many positions outside our range of vision (for instance, throwing a baseball or football). Therefore, proprioception is especially important in the shoulder joint! 

Try 3 times through the alphabet, drawing capital letters. Your stabilizer muscles will be working very hard to keep the shoulder in its proper place, and you will likely get fatigued.

Need an added challenge? Try closing your eyes.

Rehab For Shoulder Impingement Syndrome

Scapular Setting

This, in my opinion, is one of the most important facets in any chronic shoulder injury rehab!


SO many chronic shoulder injuries stem from poor posture. If you can master great posture, you can reduce your chance for many chronic shoulder injuries, such as shoulder impingement syndrome!

I refer to the shoulder blades as the ‘core’ of the upper back. Many of us complete tasks that contribute to a rounded (forward) posture: sitting at your computer and looking at your phone. As the shoulders round forward, the chest muscles tighten, the back muscles weaken and thus, the shoulders cannot move optimally. Over time this can lead to injury!  

To set your shoulder blades properly, squeeze them down and in towards each other. Notice I am not shrugging my shoulders upwards during this. It should be a pretty subtle movement by pinching the shoulder blades together. A common analogy is to imagine squeezing a golf ball between your shoulder blades.

I recommend practicing scapular setting as often as you can. For instance, when you hit a red light do 10 repetitions, or when you walk through a doorway, set your shoulder blades. At first, try to reach 3 sets of 10 repetitions of scapular setting 3 times daily. Make it a habit so this more optimal posture becomes your new normal. You should set your shoulder blades before you lift something up or reach up high for something.

Also, if you notice your shoulders rounding forward while sitting at your desk or in the car, cue yourself to set your shoulder blades back. This is a very important factor when rehabilitating and preventing shoulder injuries and it will also help you achieve better posture.

Therapeutic Workout for Shoulder Impingement Syndrome

  • Mini Band Bilateral ER: with a mini band wrapped around your wrists, set your shoulder blades and push your wrists out into the band and hold. Hold for 5 seconds and aim for 3 sets of 10
  • Scaption with Resistance band: with your arm at a 45 degree angle in front of you, stand on the resistance band and hold it in your hand with the thumb pointed to the sky. Bring the arm up (no further then shoulder height) and return back to neutral. Repeat 3 sets of 10-15 reps
  • 2 Arm Row: Set the shoulder blades and pull both ends of resistance band towards you, while keeping your elbows tight to the body. 3 sets of 10 reps
  • Ts: you can lay flat on the ground or lay face down onto a stability ball. With your arms out to the side and thumbs pointed to the sky, squeeze the shoulder blades together and return to the starting position. This is a subtle movement: aim for 3 sets of 10-15 reps

Try implementing this into your existing exercise routine!

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