One of the most common causes of shoulder pain is shoulder impingement. If you have shoulder pain, it's likely due to impingement from your daily activities. Many of our patients who come in with shoulder pain have jobs that involve repetitive motions with their arms, such as working on a computer or using a phone or tablet. Other patients have hobbies that require them to use their arms a lot, such as painting or carpentry. Too much of any of these activities can lead to impingement and pain.
In this article we will discuss what causes shoulder impingement, signs that suggest you have it, and effective stretches and exercises to help you reduce it!
What causes impingement in the shoulder?
Impingement occurs when the rotator cuff tendons become pinched between the bones of the shoulder during activities. The repetitive pinching can cause pain and inflammation in the shoulder. Impingement occurs most often in people who frequently work with the shoulder overhead (swimming, painting, baseball, tennis, golf, etc.).
How do you know if you have shoulder impingement?
- Pain or difficulty holding your arms above your head
- Pain or difficulty reaching behind your back
- Weakness in the shoulder
- Pinching feeling in the shoulder
How can you fix a shoulder impingement?
The best ways to reduce shoulder impingement are to improve posture, increase range of motion in the upper back, and strengthen the rotator cuff. With the following exercises and stretches, you can achieve all three goals!
Pec/doorway stretch
When your chest muscles are tight, it can pull your shoulder joint forward and down. This position decreases the distance between the bones in your shoulder joint and leads to increased shoulder impingement. By stretching your pectoral muscles, you can reduce the tension in your shoulder, creating more room for the tendons to move.
For this exercise, find an open door frame. Raise your arm up at a right angle and rest your forearm on the door frame. Let your upper body, head and chest lean into the doorway without turning your body to the side. You should feel a stretch in your chest muscles near the front of your shoulder.
Wall Angel
We often find that patients are unable to raise their arms above their head without affecting their posture in the neck and upper back. With this exercise, you'll learn to keep your spine upright AND raise your arms above your head. This creates freedom of movement for the scapula and reduces impingement.
For this exercise you need a free wall to lean against. Stand with your feet shoulder width away from the wall. Lean against the wall so that your head, upper back and buttocks touch the wall. Maintain wall contact throughout the exercise. Now raise your arms sideways against the wall, with your elbows forming a 90-degree angle. Slide your arms along the wall until they are just above your head and return to the starting position.
Foam Roller Stretch
This exercise combines a stretch of the chest muscles AND an overhead movement for posture. If you are able to move your arms overhead while maintaining an upright posture, you can teach your body good postural habits to allow the shoulder to move freely!
For this exercise you need a foam roller. I usually recommend a longer foam roller, but a short roller is also suitable. Lie on the foam roller in the direction of your spine with the back of your head resting on the roller. Next, place your hands on the floor by your sides. Keep your arms straight and make a half circle with them to the overhead position (similar to a snow angel). Try to keep the back of your wrist in contact with the floor the entire time.
Thoracic Rotation
Upper back rotation is an important foundation for thousands of movements (throwing a ball, swinging a golf club, shoulder check in a car, etc.). This exercise limits the movement to the upper back, so your shoulder doesn't have to do all the work in the rotation!
To perform this exercise, first get down on your hands and knees. Prop your butt up on your heels and drop one elbow to the floor. Take your other hand and place it on the back of your head. Rotate your free arm up toward the ceiling and hold it up for 2 seconds. You should feel the stretch between your shoulder blades.
Scapula Push-up
A strong upper back makes it easy for you to keep your shoulder blades closer to your spine. This prevents your shoulders from sliding forward and upward, causing shoulder impingement. A push-up end position is a great way to activate these muscles!
For this exercise, assume a high plank position (you can also bend your knees if that's too strenuous for you). Keep your elbows/arms in a closed position throughout the exercise. Squeeze your shoulder blades together and then push them as far apart as possible. When you separate your shoulder blades, imagine you are pushing the floor away from you.
I's, Y's, and T's
Again, activate your upper back muscles in a variety of ways to keep them attached to your spine during overhead movements. This is the key to preventing shoulder tightness.
This exercise consists of 3 parts. Lie face down on the floor and raise your arm up by your ears (this is the "I" position) with your thumbs pointing towards the ceiling. Then raise your arms toward the ceiling by squeezing your shoulder blades together. Repeat this in the Y position and the T position.
Banded External Rotation
Take a mini ribbon loop or create a loop with an existing ribbon you have. Place both hands in the loop so that your palms face each other. Bring your elbows to your sides so that your forearms are pointing straight ahead. Push your hands away from each other while keeping your elbows at your sides.
Next Steps?
These at-home exercises are a good place to start if you feel signs of shoulder impingement. However, the shoulder is a complex joint and these simple exercises don't always work for everyone. If you're not sure what's causing your shoulder pain, if you need extra help improving your posture, or if you notice you're not getting the improvement you want, we're here for you!
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Dr. Mike Hadbavny
Victoria Sports Chiropractor FRCCSS(C)
If you are interested in learning more about how chiropractic care can be effective for your particular condition or health goals, contact Dr. Mike Hadbavny at 250-881-7881 today to make an appointment and discover the many benefits of seeing a chiropractor in Victoria BC. Contact us today.