How Can Physical Therapy Help Shoulder Impingement?

You may have heard of shoulder impingement at the gym or from a coworker talking about their aches and pains. Shoulder impingement is a phrase people may commonly hear—such as sciatica or plantar fasciitis—but not everyone knows what it actually means. In casual conversation, I have heard people refer to shoulder impingement as a catch all condition that may or may not be accurate. So let me map out what is shoulder impingement, why do people get it, and what you can do about it.

Shoulder impingement as a diagnosis is inflammation of the tendons and connective tissues in the shoulder. Often the tendons of the rotator cuff muscles, biceps tendon, and several other tissues are involved. This inflammation can cause pain and discomfort and, in general, can make it difficult to reach overhead, across your body, or behind your back. Many times impingement can develop slowly, first as a small pain and then as a growing irritation.

Often, people develop shoulder impingement because of weakness in the shoulder. Specifically, weakness in the rotator cuff muscles commonly leads to impingement. The rotator cuff muscles’ main purposes are to rotate the upper arm bone (the humerus) and to stabilize the humerus as you move your arm. If the rotator cuff is weak, then the top of your humerus might bump into the shoulder blade and pinch tendons and other soft tissues, causing inflammation.

Another common problem area is the rotator muscles of the shoulder blade (the scapula). As you reach overhead, your shoulder blade must rotate upwards, but if your muscles are too weak or uncoordinated to perform this activity, the tendons and other soft tissues in the shoulder can get pinched. Shoulder impingement is very common in people who do repetitive overhead activities because the more you do an activity, the more fatigued a muscle gets, and the more likely the muscle will not do its job. Many of my patients with shoulder impingement do overhead activities such as painting, weightlifting, tennis, and construction, but even everyday activities can cause impingement, such as reaching into a cabinet or washing walls.

As Physical Therapists at Abound Performance Physical Therapy, we have many tools to help patients alleviate their shoulder impingement. First, we discuss patients’ current limitations and their ultimate goals. Whether it’s cleaning a tub or playing basketball, we prioritize your goal and determine how best to reach it. Then we do tests to determine if shoulder impingement is the correct diagnosis and evaluate which tendons and tissues are irritated. From this point we target the inflamed tissues with soft tissue mobilization (a form of massage) to decrease the inflammation and pain, while strengthening the muscles that are weak and are not doing their job. Over time we will load the muscles more and do exercises that simulate your goal activities, so that you can get back to the activities you love. Our goal is to not just fix the problem, but to ensure it does not return.

Ultimately, you need a customized plan to correctly diagnose shoulder impingement, identify which muscles and tissues need to be rehabbed, and go through targeted, progressive exercises to return to your favorite activities. You can find many resources online about shoulder impingement and videos that claim, “Do These 5 Exercises to Get Rid of Shoulder Impingement,” but these self-help resources do not identify what you as an individual need. You may get better after trying different exercises for months and years, but why not save yourself time and effort by seeing a Doctor of Physical Therapy for a comprehensive evaluation and a customized treatment plan to get you back to the active lifestyle you love.

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Abound Performance Physical Therapy is located in Colorado Springs, CO and helps active and athletic adults who love to move through life. Whether your goal is to get dressed without pain or to rock climb at Garden of the Gods, at Abound, your goal is our goal.