Shoulder impingement is characterized by pain in the shoulders when raising the arms above the head. It can become a serious condition if left unmanaged. It can lead to tears in the muscle and may result in muscle weakness and deterioration. If you suffer from impingement, you can perform the exercises listed below daily to relieve symptoms and prevent complications.
There are lots of factors that contribute to the development of shoulder impingement. However, the most common and most notable is repetitive movements. Repetitive overhead movements like cleaning areas too high up, swinging a golf club, frequent swimming, and other similar activities contribute to the development of impingement. Exercises that are improperly performed can also contribute to the development of this condition.
There are a number of treatment options available. Topical and oral analgesics, NSAIDs, and/or steroidal pain relievers may be given to reduce the pain. Physical therapy might also be needed to correct and restore functions in the affected area. In severe cases, surgery may be required. In this case, the condition may have already caused severe structural damage to the affected shoulder.
Physical Therapy Exercises – Stretching
These stretching exercises will help in improving your range of motion. This will help the involved muscles and tendons regain their normal function by loosening them up. The following are stretches that can help.
Perform these every day for about 6 weeks to achieve optimum results. Per day, perform 3 to 4 sets each of these exercises. For each stretch, hold it for 20 to 45 seconds to achieve the optimum effect.
Beginners should perform 2 to 5 sets per day and hold the stretch for 10 to 30 seconds.
- Start by lying with your back flat on the floor. Bend your knees and keep your feet flat on the ground.
- Slowly stretch the affected arm up over your head. Use the other arm as this may be difficult and painful at first.
- The goal should be to bring the affected arm down to the floor beside your head.
- Hold this position for 10-30 seconds. Return the arm to the normal position if the pain becomes unbearable. Rest and try again after 20-30 seconds.
Some people may find the above stretching exercise to be too uncomfortable and/or painful. Fortunately, there are some stretching exercises that may also be performed while standing or sitting down.
- Place the affected arm across your chest towards the other side.
- Gently stretch the injured arm by crossing the other hand over the elbow of the injured hand and then press on it. Avoid lifting the shoulder towards the ear.
- The stretch should be felt at the back of the shoulder and over the upper arm. If you feel any sharp pain, reduce the pressure. If the sharp pain persists, stop the exercise and rest. Try again after 20-30 seconds.
To stretch the front of the shoulders and the chest, you should perform this exercise while standing.
- Stand, face a corner, and extend both arms to the corner. Place your palms flat against the wall on the sides of the corner and lean towards it slowly. The stretch should be felt over the front part of the shoulders and over the chest area.
- Another exercise is to hold the sides of a door frame. Position your hands at shoulder height. Start to slowly lean away from the door. This will create a stretch over the arms and chest. Again, if you feel any sharp pain, reduce the pressure by leaning slightly towards the door. Stop immediately if the pain persists.
Strengthening therapy exercises
Strengthening exercises are just as important as stretching as these will reduce the risk of injuries and help the affected muscles recover more quickly. This also retrains the scapula in order to get rid of any compensatory movements it has developed.
Lastly, this also reduces the risk of serious injuries from muscle weakness that may require surgery.
These exercises should be performed 3 times a week. You should perform 3 to 5 sets with 10 to 20 repetitions each, resting for 30 seconds in between sets.
While standing up
- Face a wall and stand close to it.
- Place your arms up over your head to form a “V.” Your little fingers should be against the wall and your thumbs should be pointing backwards towards the shoulders.
- Shrug the shoulders in an upward direction to allow your hands to slide up further.
While lying on the floor
- Lie face-down on the floor. Your head should be positioned looking directly ahead or to the side.
- The affected arm should be lying by the side of your body in a relaxed manner.
- Lift the affected shoulder upwards to create a 5-cm gap between the shoulder and the floor.
- Keep the shoulder lifted straight up, not forwards towards the ear.
- To increase the difficulty, lift the entire affected arm up and then lower it down to the floor while keeping the elbow straight. The shoulder should be kept off the floor the entire time.
- Stand up straight and keep your elbows straight with your thumbs pointed towards the ceiling.
- Slightly squeeze your shoulder blades. Raise your arms above your head as high as possible without feeling any pain.
Abduction exercise (targets the scapula plane)
- Stand straight with your feet flat on the floor.
- Keep the affected shoulder by the side of the body.
- Slowly lift the affected arm up and away from the side.
These strengthening exercises can also use weights, or resistance bands for more intense and effective treatment. By using weights or bands, the resistance will help further strengthen and retrain the affected muscles.
You should follow the progressive overload principle. That means starting with lower weights and gradually increasing each week by 0.5 to 1 kg.
For example, you can perform strengthening exercises on Monday, Wednesday and Friday, with 3 sets, with 10 reps for each set.
For this first week, use 1 kg weights. The next week, do the same workout but with 1.5 kg weights. Do this for 6 weeks. Note that the weights should not be more than 4 kg.
A few reminders:
During the first 1 to 2 weeks of training, you can expect that pain will slightly increase. It is also normal for the muscles to feel fatigued or a general ache. These are not indications that you should stop performing the exercises.
However, if the pain is sharp, that’s a bad sign indicating the exercise is not performed correctly. Stop and get a therapist’s help to prevent additional injuries.
The symptoms should subside after 4 to 6 weeks of regular and correct exercise. If they don’t, then you should consult a therapist. The condition may require other types of treatment. If you experience any improvement, you should continue these exercises for another 2 to 3 weeks.