Your shoulders, as the most mobile joint in your body, bear a lot of load during upper-body exercises and daily activities. They’re always working to keep your arms stable while you’re performing tasks such as lifting weights, carrying heavy groceries, or swimming. However, if you feel pain in your shoulders when you lift a weight overhead or while playing some sports such as tennis or swimming, it may be time to see your doctor. You may have shoulder impingement, which is treatable but requires close monitoring and possibly a few sessions with a physical therapist or a doctor. Muscle imbalances around the shoulder are almost always present in patients with shoulder impingement, resulting in abnormal biomechanics.

What is Shoulder Impingement?

Shoulder impingement is a frequent cause of shoulder pain. It is also commonly known as impingement syndrome or swimmer’s shoulder since it’s more common among swimmers. Other athletes such as softball or baseball players, who use their shoulders a lot, are also prone to it.

Shoulder impingement begins in the rotator cuff. A rotator cuff is a group of muscles and tendons that connect your upper arm bone to your shoulder bone. The rotator cuff assists you in lifting and rotating your limb. Shoulder impingement occurs when the top outer edge of your shoulder blade, known as the acromion, rubs against the rotator cuff. When you raise your arm, the space between the rotator cuff and the acromion is compressed by your upper shoulder joint, increasing pressure. The rotator cuff is irritated by the increased pressure, which results in impingement. Shoulder impingement usually causes inflammation of the rotator cuff tendons and bursa, which can be very painful. It is important to note that the tendons will tear if the condition is not treated on time.

The symptoms of shoulder impingement include:

• Minor but persistent pain in the arm
•  Pain that worsens at night
• The weakness of the shoulders or arms
• Pain that runs from the front of the shoulder towards the side of the arm

If the symptoms are not treated, the supraspinatus muscle tendon can fray or be damaged, resulting in bursitis (bursa inflammation) or more chronic pain.

Causes of shoulder impingement:

Shoulder impingement is caused by damaged and injured shoulder muscles and tendons. Shoulder impingement is more common in people over the age of 50, but it can affect anyone at any age. Overuse of the shoulder joint is the most common cause of shoulder impingement. This is common in active adults who participate in sports such as swimming, tennis, baseball, or heavy overhead weightlifting.

Treatment of Shoulder Impingement:

When a person suffers from shoulder pain, they can try a variety of treatment options to relieve the discomfort. The treatment options include pain killers, heating pads, and ice packs. To better diagnose your shoulder injury or pain, you should see a doctor or a physical therapist.  In addition to this, if you’ve been diagnosed with shoulder tendonitis, there are a few shoulder impingement exercises to avoid.

7 Shoulder Impingement Exercises to Avoid

If you are suffering from shoulder impingement, you should avoid behind the neck press, upright row, behind the neck pulldown, pushups, freestyle swimming, triceps dips, and pushups. You should also avoid lifting weight above your head and give your injury time to heal.

1.Behind-the-Neck Press:

This is one of the shoulder impingement exercises to avoid. This overhead press variation is an exercise you might have seen the bodybuilders do at the gym, but it needs a range of movement that most people don’t have, particularly if you have shoulder impingement. The rotator cuff muscles, which stabilize your shoulder joints, are put under a lot of pressure when you do a behind-the-neck press. The position of this exercise is also uncomfortable. You could strain a shoulder muscle if you have poor shoulder mobility or if your weight is too much.

You can also injure your spine. The barbell can hit your neck or the back of your head during the downward phase. It also puts a lot of pressure on the muscles in your neck.

According to Cameron Yuen, a physical therapist at Bespoke Treatments in New York City, “One of the primary pathways to developing shoulder impingement pain is pushing a load overhead into a range of motion you don’t have. If this action is repeated, it will begin to sensitize an already irritated rotator cuff tendon and bursa.” 

2.Upright Row:

Although upright row is one of the most common exercises at the gym, a closer examination of the mechanics of this exercise reveals that it is a terrible exercise for rotator cuffs and other shoulder injuries. 

The main problem with this exercise is the posture in which your arms must be kept. This position is commonly known as “internal rotation”. When you lift your arms up, the shoulder bone squeezes a small tendon located in the shoulder. Over time, this can lead to excessive wear and tear. You may not notice it right away, but with time your tendon will become worn down and damaged and eventually lead to shoulder impingement pain.

3.Lifting Weights Above Your Head:

Excessive strain or lifting excessively heavy weights over your head may result in inflammation, a change in tissue alignment, and involuntary movement in the shoulders and arms. These problems will prevent the tendon from moving freely, resulting in pain in the affected region.

Exercises that require lifting or overhead movements should be avoided by patients with shoulder injuries and shoulder pain. Activities such as throwing a ball or doing basic weight training exercises at the gym, such as overhead presses and pull-downs, should be totally avoided.  These movements will put the injured area under more stress, resulting in more injury and pain.

4. Behind The Neck Pulldown:

The behind-the-neck pulldown, whether performed with a barbell or a bar attached to a cable, is a shoulder impingement exercise to avoid. This movement places a lot of pressure on the rotator cuff, putting you at risk for more shoulder injuries and chronic pain. The main problem with this exercise is in the position of “external rotation”. In this exercise, you are required to externally rotate your shoulders as much as possible, which puts your shoulder in a delicate position. This movement can make the joints unstable and cause tissue overstretching, which can lead to injury and shoulder pain.

5.Triceps Dips:

The triceps muscles are the primary muscle group targeted by dips. Dips provide strength to your shoulders, chest, and triceps all at once, but this exercise also places you in a position of severe shoulder extension, which may worsen the impingement symptoms.

To perform this exercise, the shoulder has to be at the end range of its extension, causing the humeral head to move forward. The rotator cuff tendon and bursa are both placed under more stress by this exercise but in a different way. When the arm is behind the body, the shoulder is pinched, compressing the space and likely irritating a different position on the tendon, which eventually leads to shoulder injury or shoulder impingement issues.

6. Pushups:

Pushups are a perfect workout to include in your routine because they work all of your muscles in your body. Pushups are mostly an upper-body exercise, targeting the chest, arms, and upper back, but they also engage the core and leg muscles as you maintain a straight body plank position.

Muscle soreness is normal, particularly if you’re not used to doing pushups. If the pain doesn’t go away in a few days, it may be one of the symptoms of something more severe. Pushups can cause shoulder pain due to their repetitive motion, especially if they are performed incorrectly. This can put a strain on the rotator cuff, resulting in injury and pain. Extreme external rotation in your shoulder as a result of performing the pushup too quickly or lowering too far down with incorrect elbow position can lead to rotator cuff problems, such as rotator cuff tendinitis. If not diagnosed and treated correctly, rotator cuff pain from pushups can worsen and last for years. So, if doing pushups hurts your shoulders, stop this exercise and consult a doctor first to avoid any further injury.

7.Freestyle Swimming:

Internal shoulder impingement can be detected by sharp pains in the shoulder, especially at mid-catch when swimming freestyle. When the arm is stretched out front, pinching in the shoulder may indicate rotator cuff impingement. Only a doctor can diagnose a shoulder injury, which is usually performed with a combination of physical therapy and an MRI scan.

A common cause of shoulder impingement issues in swimmers is the overuse of their shoulders. They swim a lot of freestyle. As a result of these movements, the shoulders are in constant motion and moving in the same direction. This can result in an overuse of muscles in the front of the shoulder and underuse of muscles in the back, resulting in labral tears and rotator cuff and internal shoulder impingement. In order to avoid muscle imbalance, it is important to develop a good symmetrical body rotation while swimming.

Some Other Ways To Avoid Worsening of Shoulder Impingement

1.Balance Your Muscles

One of the ways to avoid shoulder impingement is to focus on balancing your muscles. Muscle imbalance is the second most common cause of shoulder impingement. People frequently neglect the muscles in the back of their shoulder blades, focusing more on the muscles in the front of the shoulder and chest. Read here about the meditations to relieve back pain

This can make your shoulder blades unstable, which affects the way your shoulder functions and puts you at risk of inflammation. Any upper body push exercise should be followed by a pull exercise to help avoid these imbalances. That is, if you do a pushup, you should also do some rows. Pull-ups can be done after an overhead press.

2.Smart Training

Doing too much too soon is the leading cause of shoulder impingement. Make sure you’re ramping up your training at a reasonable pace if you want to get in shape quickly before the weather warms up.  Every exercise program should have some sort of introduction phase. Consult your personal trainers if you’re just getting started with exercise. Likewise, if you’re returning to baseball or softball, raise your pitch counts gradually. There’s always a smart way to get started on whatever path you choose for your health.

3.Keep Inflammation Under Control

This next piece of advice may seem obvious, but it’s often ignored by some people.  It is common for muscles to get inflamed during rigorous exercises, however, it’s important to keep small amounts of unavoidable inflammation under control to avoid having a minor irritation turn into an impingement. After a hard workout, it’s a good idea to apply ice to your shoulder for about 20 minutes. Ensuring that you get enough rest is perhaps the most important factor in reducing irritation and soreness in the shoulder region. This means taking enough breaks during exercises and getting the proper amount of sleep at night.

4.Keep an Eye On Your Posture

People slouch forward in their chairs throughout the day, causing their shoulders to round forward. This position reinforces some poor shoulder movement, which can quickly result in inflammation. Keeping your chest open, your shoulders back, and shoulder blades stable will help you improve your stance significantly. Read more about relieving back pain with posture control.

5.Move Correctly

This last piece of advice is aimed more at overhead athletes such as pitchers, throwers, etc.  When it comes to activities such as throwing, proper mechanics are crucial for maintaining your shoulder strength and health. A skilled specialist will help you reduce the risk of injury by properly analyzing your throwing style.

Physical Therapy for Shoulder Impingement Syndrome

When shoulder impingement syndrome develops, it’s important to take care of it as soon as possible. If left untreated, it can lead to secondary conditions such as:

• Irritation of the bursa
• Tearing of the rotator cuffs
• Problems related to serratus anterior

Shoulder impingement syndrome can be successfully treated with physical therapy. Your physical therapist will collaborate with you to design a recovery process that fits your needs and objectives. Therefore it is important that you avail chiropractic services. The following items can be included in your individualized treatment plan:

1.Patient Education:

Your physiotherapist will explain your condition to you and then explain the recovery process that will follow. They’ll work with you to figure out what’s causing your discomfort. They may advise you to adjust the type and amount of exercises you perform, as well as your athletic activities and activities at home or at work. They’ll create a customized fitness routine for you to ensure a pain-free return to your desired activities.

2.Pain Management:

Your physiotherapist will devise a treatment plan for you that involves icing the affected region. They might also suggest that you change some of the activities that are causing you pain. Physiotherapists are experts at administering pain-management procedures that minimize or reduce the need for medicines, such as opioids.

3.Range-of-motion exercises:

The shoulder joint and scapula have limited mobility. Various structures are placed under more stress as a result of this. Your shoulder may be forced to function inefficiently as a result of your condition. Self-stretching exercises taught by your psychotherapist can help to relieve stress and restore normal shoulder motion and arm function.

4.Muscle Strengthening:

Muscle weaknesses or imbalances may lead to injury or impingement of the shoulder joint as the scapula deviates due to fatigue and weakness. You may start by doing strengthening exercises by lying on a treatment table or on your bed or floor at home. After that, you should move on to standing exercises. Based on your age and physical health, your physical therapist will determine which exercises are appropriate for you. Your plan may include resistance band exercises.  Resistance band exercises for shoulders are efficient and easy to do, making them ideal for people of all fitness levels and abilities. Resistance band exercises are simple to incorporate into your current workout routine. In addition to this, you may also use a foam roller in your exercises. It aids in muscle repair and alleviates soreness.

5.Functional Training:

You’ll need to gradually return to more challenging activities once your pain, stamina, and range of motion have improved. It is important to teach the body safe and coordinated movements in order to reduce stress on the shoulder joint. Your physiotherapist will design a series of activities based on your motion assessment and goals to help you learn how to use and move your body safely and correctly.

Bottom Line

Although shoulder impingement can be painful and affect your everyday activities, most people recover fully within a short period of time. In most cases, you’ll only require some rest and physical therapy. However, if they don’t work, you may need surgery, which can add several months to your recovery period. Therefore it is highly recommended that you avoid the exercises that can exacerbate the inflamed musculoskeletal system of the pectorals.