Your shoulder joint is one of the most mobile areas in your body. But if you’ve been having difficulty with shoulder range of motion — say, when lifting your arm or reaching behind your back — you could be dealing with shoulder impingement. 

Shoulder impingement is when internal structures of your shoulder rub against (or impinge on) each other, which can contribute to symptoms like pain and weakness. “When I see a shoulder pain patient, it’s usually due to some form of impingement,” says Caitlin Shaw, PT, DPT, a physical therapist at Hinge Health. 

Shoulder impingement can affect your ability to do everyday activities you don’t normally have to think about, such as brushing your hair, getting dressed, and throwing a ball. Though the symptoms can be alarming or frustrating (especially if you’ve never experienced them before), shoulder impingement usually responds well to at-home treatment options, including stretching and strengthening exercises. 

Here, learn more about shoulder impingement, including common causes and how to treat it, especially with exercises from our Hinge Health physical therapists. 

What Is Shoulder Impingement?

Shoulder impingement is often characterized by pain when you raise your arm to shoulder height or above. It occurs when various structures within the shoulder become irritated. 

The space in the shoulder joint is pretty compact. When your arm is raised, it narrows. In the case of shoulder impingement, swelling further reduces the amount of available space, which can make tissues feel “pinched” when you raise your arm. Think of an office elevator during rush hour compared to a quieter time of the day. When the elevator is packed, it becomes less comfortable.

Shoulder impingement commonly occurs when the rotator cuff tendon gets irritated and inflamed, which reduces the space around the tendon. As a result, it rubs against the shoulder blade, causing discomfort. (The rotator cuff is a group of muscles and tendons that lift and rotate your arm.)

Impingement can involve other structures in your shoulder too, including the fluid-filled sacs (bursae) that protect the shoulder joint and allow tendons and bones to glide without friction when you move and lift your arms. Bone spurs can also tighten the space around your rotator cuff. 

Symptoms of Shoulder Impingement

Symptoms of shoulder impingement are typically gradual, occurring over weeks to months with pain that occurs during motion, particularly reaching overhead or backward. “I sometimes ask people how it feels when putting a belt through their pants,” says Dr. Shaw. “Or with female patients, I may ask whether it hurts to hook your bra in the back.” While it may start with more subtle symptoms, impingement may develop into a constant “toothache-like” pain. You may also experience pain at night when you sleep.

Main Causes of Shoulder Impingement

Anyone can develop shoulder impingement, but it’s most commonly seen in people who:

• Do sports or other activities with a lot of overhead rotational motion, like tennis, volleyball, baseball, and swimming. (Shoulder impingement is sometimes called swimmer’s shoulder.)

• Perform repetitive lifting or overhead activities, such as construction work, window washing, painting, hairdressing, and stocking shelves. 

• Have shoulder arthritis. Inflammation from osteoarthritis can result in extra bone deposits, leading to bony growths or bone spurs. These can irritate the bursa and the tendons by reducing the amount of available space, causing discomfort and inflammation. 

However, doing these activities does not mean shoulder impingement is inevitable. And it’s important to engage in sports, hobbies, and work that you enjoy without fearing movement. As you’ll see below, if shoulder impingement is contributing to your shoulder pain, there’s a lot you can do to treat and prevent it while still engaging in the things you need and want to do.

How to Treat Shoulder Impingement

The following treatment options can help reduce pain and improve shoulder function:

• Physical therapy. A physical therapist can provide an individual treatment plan that focuses on improving your range of motion and strengthening muscles. According to a recent study, “exercise therapy should be prioritized as the primary treatment option, due to its clinical effectiveness, cost-effectiveness, and other associated health benefits.” You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Over-the-counter medication. Pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol), can help ease swelling and pain associated with shoulder impingement. Make sure that you’re able to take these medications, based on your medical history.

• Cold therapy. Apply ice for 10-20 minutes twice a day to quell inflammation and swelling. 

• Elastic therapeutic tape (or kinesiology tape). Kinesiology taping helps to gently stabilize the shoulder, potentially reducing inflammation and swelling. The tape can also provide some stability to your muscles during strengthening exercises (see below). Keep in mind: This is a temporary pain relief tactic to help you stay active while your body recovers. For long-term relief, exercise therapy is your best bet.

• Nighttime relief. If sleeping on your side is painful, sleep on your unaffected side or on your back with your arm at your side to keep it in alignment with the rest of your body and avoid putting pressure on your shoulder for prolonged periods. If you’re a stomach sleeper, you can place a pillow underneath your hips and pelvis (this will help align your lower body with your upper body to prevent your shoulders from sagging) and rest your face toward the shoulder that bothers you.

• Activity modification. You may be tempted to swear off exercise and activities while your shoulder hurts, but that’s not what Hinge Health physical therapists recommend. Rather, start doing shoulder impingement exercises (see examples below) until you’re able to do activity-specific overhead movements (e.g., serve a tennis ball) without pain. It’s also important to continue doing other forms of exercise and movement, like walking, stair climbing, and water aerobics classes.

When to See a Doctor

Shoulder impingement can usually be managed with at-home care. If your symptoms haven’t improved or are getting worse after four to six weeks though, it’s a good idea to see a doctor. They may recommend physical therapy or another treatment. 

You should also seek a doctor’s care if you develop increased weakness, radiating symptoms like numbness or tingling, or other symptoms that might be red flags for a different problem (like a neck issue). 

These shoulder strengthening exercises recommended by Hinge Health physical therapists help activate key muscles in your shoulder, upper arm, and back. This helps to restore appropriate space in the joint and reduce inflammation and irritation in the surrounding tendons that tend to cause the symptoms of shoulder impingement.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Prevent ‘Mouse Shoulder’ at Your Desk

Working at a computer for long periods can contribute to muscle tightness that plays a role in shoulder impingement pain. Discomfort is usually most noticeable on the side you use the computer mouse. To avoid what’s known as “mouse shoulder,” be sure to have a proper resting point for your arms and wrists as you type and use your mouse. “Sometimes, people don’t even rest their arm on the table or desk,” notes Dr. Shaw. “Their arm is in the air as they move the mouse around.” But resting your arms and wrists on something helps take some of the stress off them. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Shoulder Impingement Syndrome. (2021, January 5). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/7079-shoulder-impingement-syndrome

2. Pieters, L., Lewis, J., Kuppens, K., Jochems, J., Bruijstens, T., Joossens, L., & Struyf, F. (2020). An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain. Journal of Orthopaedic & Sports Physical Therapy, 50(3), 131–141. doi:10.2519/jospt.2020.8498

3. Shoulder Impingement/Bursitis. (n.d.). Windsor Upper Limb. https://www.windsorupperlimb.com/conditions/shoulder-conditions/shoulder-impingement-bursitis

4. Lee, B. (2019, February 22). Shoulder Pain: Is it Shoulder Impingement? Sports-Health. https://www.sports-health.com/sports-injuries/shoulder-injuries/shoulder-pain-it-shoulder-impingement

5. Armstrong, A. D. (2021, July). Shoulder Impingement/Rotator Cuff Tendinitis. OrthoInfo – American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis

6. Creech, J. A., & Silver, S. (2020). Shoulder Impingement Syndrome. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554518/