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Physical Therapy for Shoulder Impingement: Treatment and Exercises


Shoulder impingement is a common condition that affects a significant part of the population.


The syndrome usually causes pain, stiffness, and discomfort in the shoulder area and may lead to decreased quality of life.


One of the best ways to treat shoulder impingement, help decrease pain, and improve the range of motion is physical therapy.


Physical therapy for shoulder impingement offers a wide range of modalities that, over time, can help patients get back to living pain and restriction-free lives.


What is Shoulder Impingement Syndrome?


Shoulder impingement syndrome is a condition when the shoulder blade (scapula) rubs against the collarbone (clavicle), and the tendons and soft tissue under the acromioclavicular (AC) joint become inflamed, irritated, or swollen due to repeated compression.


This condition may also be called "subacromial" impingement syndrome.


The affected areas include:


  • Rotator cuff tendons (most commonly affected)

  • Bursa (a fluid-filled sac between joints)

  • The long head of the biceps tendon (LHBT)

  • Ligaments.


People who perform repetitive overhead motions are most likely to develop shoulder impingement. A shoulder injury and trauma can also lead to this condition.


The condition is common among people whose work includes a lot of time with arms above their heads, such as construction workers, factory workers, and office employees.


Sports such as lifting, swimming, tennis, and others, as well as poor posture, may also increase your chances of developing shoulder impingement syndrome.


Shoulder impingement should not be left untreated as that may lead to even more severe conditions.


What Are the Symptoms of Shoulder Impingement Syndrome?


Before we talk about how to fix shoulder impingement, physical therapy for shoulder impingement, and exercises for shoulder impingement, let's take a closer look at its symptoms.


People with shoulder impingement syndrome may experience:


  • Restricted shoulder motion when lifting heavy items, raising arms above the head, throwing, or reaching across the body.

  • Shoulder pain when sleeping on the affected side.

  • Tenderness in the shoulder area and pain in the upper arm.

  • Swelling in the front of the neck and its area/


Physical therapy for shoulder impingement can help relieve these symptoms and prevent further damage as it loosens the shoulder muscles, strengthens them, and improves the range of motion.


What are the Main Causes of Shoulder Impingement?


It's important to understand what has caused the condition in the first place to prescribe the best shoulder impingement physical therapy, treatment, and shoulder impingement syndrome exercises.


There are a few causes for shoulder impingement syndrome, including:


  • Repetitive overhead movements and shoulder overuse (tennis, painting, swimming, construction work, etc.)

  • An acute injury to the shoulder

  • Poor posture

  • Shoulder joint degeneration

  • Abnormalities of the acromion (the top outer edge of the shoulder blade).


How Is Impingement Syndrome Diagnosed?


A physical therapist (PT) assesses the patient's condition or injury, and an X-ray will be done to help confirm shoulder impinging syndrome.


Before prescribing any therapy or impingement syndrome shoulder exercises, the PT evaluates the severity of the condition or injury and determines the causes.


The assessment will include questions about the symptoms and medical history.


For example, they may ask if you've had any recent injuries or surgeries. They'll also want to know what exercises patients do regularly and whether they exercise at home. This helps PTs understand the condition and consider the best course of treatment.


Besides asking questions, the physical therapist will also observe the patient's movements, such as moving the arms and shoulder, to assess:


  • Strength and mobility

  • How well can the patient perform the tasks

  • Which areas are mostly affected


Lastly, they will use their hands to touch and feel the affected areas for better diagnosis.


Shoulder Impingement Syndrome Treatment


It is crucial to start treatment for shoulder impingement syndrome as soon as possible as otherwise, it can lead to such severe conditions as irritation of the bursa and rotator-cuff tears.

Shoulder Impingement Syndrome Treatment

It is also important to reduce and eventually eliminate pain and increase the range of motion for a better quality of life.


Physical therapy and shoulder impingement physical therapy exercises can successfully treat shoulder impingement syndrome.


The physical therapist creates a safe, personalized treatment plan with specific goals tailored based on the patient's condition.


How Can a Physical Therapist Help?


Your personalized physical therapy program may include:


Pain management. The PT will focus on alleviating pain and might suggest changing certain activities that cause it as well as teach pain relief techniques that reduce or eliminate the need for medication.


Patient education. The therapist will help identify external factors causing pain, make recommendations about changing the type and amount of physical activity, home or work activities, and develop a customized exercise program.

How Can a Physical Therapist Help?

Range-of-motion exercise. Teaching self-stretching techniques to decrease tension and impingement syndrome exercises is an important part of any treatment plan. Performing these helps restore shoulder mobility and arm function.


Muscle strengthening. Extensive rehabilitation usually includes muscle strengthening, stretching, and range of motion exercises. The patient begins with gentle stretches and exercises lying and then progresses to movements in a standing or sitting position. The physical therapy exercises for shoulder impingement may include weights, elastic bands, ankle braces, and later even visits to the gym.


Functional training. The physical therapy shoulder impingement exercises may include exercises to improve strength, balance, flexibility, coordination, or endurance.


Manual therapy. Physical therapy for shoulder impingement syndrome often includes hands-on treatments (manual therapy). Techniques and modalities such as massage, ice, TENS, and others help improve motion and reduce pain.


Exercises for Shoulder Impingement Syndrome


Besides exercising with their physical therapist, patients can perform specific exercises at home to speed up recovery.

Exercises for Shoulder Impingement Syndrome

Here are 5 common physical therapy exercises for shoulder impingement syndrome.


Always consult a professional before doing these exercises at home.


Doorway Chest Stretch


The doorway stretch is one of the impingement syndrome exercises that will help loosen up the shoulders and chest area.

Doorway Stretch

  • Place the elbows and hands in line with a doorframe.

  • Slowly start stepping through the door to feel a light stretch. Hold for 15-20 seconds.

  • Return to the initial position and repeat 3-4 times.


Thoracic Extension Exercise


Thoracic (the middle section of the spine) extension is a crucial part of any range of shoulder impingement stretches. It's essential for neck, shoulders, and arm health.


Thoracic Extension Exercise

Props: foam roll or a rolled-up exercise mat.


  • Lie down on your back, feet on the floor, and knees bent. Place the foam roll or the mat under the shoulder blades.

  • Put the hands behind the head and arch the back, extending the spine over the roll or the mat. Hold for 10 seconds (or less if it's too difficult). Repeat 8-10 times.


Cobra Lifts


It's an excellent exercise for maintaining proper posture, opening the chest, strengthening the middle and lower back, and stretching abdominal muscles.


Cobra Lifts

  • Lie on the mat on the stomach and place the hands directly under the shoulders, palms down.

  • Exhale, press the hips down, externally rotate arms, and lift off the floor.

  • Squeeze the shoulder blades and hold for a few seconds. Repeat 8-10 times.


Internal Rotation Exercise


Internal rotation exercises help strengthen the rotator cuff, increase shoulder joint stability, and improve range of motion.


Props: a resistance band.


  • Place the band on the door handle and stand beside it sideways.

  • Grap the other side of the band with one hand while keeping the elbow bent.

  • Move the hand across the body while rotating the shoulder without moving the elbow. Repeat 10-12 times.


Shoulder Blade Squeeze


This exercise is excellent for shoulder and arm stability and helps improve posture and avoid rounded shoulders.


  • Stand or sit on a stool. Straighten the back.

  • Pull the shoulder blades together, hold for a few seconds and relax.

  • Repeat 8-10 times.

  • It's a very simple exercise you can repeatedly do throughout the day.


Can This Injury or Condition be Prevented?


It is always better to prevent a condition than to later treated.


Can this Injury or Condition be Prevented?

Shoulder impingement syndrome can be prevented by:


  • Maintaining proper muscle strength. This includes maintaining adequate shoulder, neck, middle back, and arm range of motion and mobility. When the muscles are weak, shoulder impingement and injury risk increase significantly.

  • Improving posture. Keeping proper posture can help reduce shoulder impingement risk too. It's key to avoid poor posture habits such as spending many hours hunched over at a computer and other forward-head and rounded-shoulder postures (using phones and tablets)

  • Maintaining shoulder and back flexibility and balance. Shoulder and back injuries can occur if there is an imbalance in muscular strength, as the shoulder relies upon the mobility of neighboring joints to maintain healthy, proper functioning. That's why it's key to ensure that both sides of the body are balanced.


Final Thoughts


Many people suffer from shoulder impingement syndrome. It's a condition when the shoulder blade rubs against the collarbone and causes pain, discomfort, and reduced range of motion.


The syndrome can be caused by injury, repeated motion over an extended time, or poor posture.


Physical therapy for shoulder impingement is an effective way to treat the condition and help patients go back to living full lives.

Physical therapists, like the ones at Miracle Rehab Clinic, examine each patient and create an individualized program with impingement syndrome exercises and various hands-on treatments.


Maintaining shoulder and back health and strength can help prevent the condition altogether.

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