What Causes Shoulder Impingement (And how to start treating it)

Most everybody has heard of shoulder impingement, from a doctor, from a coach, from Dr. Google even.

But what exactly is it?

First of all, imagine the shoulder, with all of its muscles, and all of the tendons wrapping tightly around the ball of the humerus (at the top). Some of these tendons are running through small holes in the bone, or are wrapping underneath the overhang of the shoulderblade.

If any of these tendons get irritated, puffed up, or inflamed, it makes this already small and tightly compact space even tighter! As the tendons get more inflamed and take up more space, they’re going to get pinched by the head of the humerus and the overhang of the shoulderblade, leading to that pinching feeling.

There are even tiny jelly filled sacs throughout the shoulder that help buffer and protect these tendons, called Bursa, but if they get irritated and swell, they too can get pinched with any movement overhead.

This irritation causes pain when lifting the arm, usually a sharp stabbing “ow” in a particular spot, and it may also show up if you try to tuck your hand behind your back.

What causes this kind of impingement and irritation?

Impingement syndrome is really common in individuals who perform a lot of overhead activities, which makes sense. The more that arm is up, the more likely those tendons are likely to get aggravated, and it’s a self-perpetuating process. Overhead athletes and swimmers are also vulnerable to impingement for the same reason!

So, what’s the best protocol if you’re dealing with impingement?

First of all, most people say rest, but that’s not what I’m going to tell you. If we could rest away our pain, we’d all take naps and be training like Olympians.

With shoulder impingement, that pain is important information, so let’s use it!

  1. If you experience more than 1-2 degrees of pain with an activity, that’s information that there’s pinching, a loss of blood flow, and generally not good stuff happening. So, aim and perform activities that are only a 1-2 level of irritation and pain. This way, you can keep training without injuring yourself!

  2. Work on training lower! What does that mean? If you’ve got pain lifting overhead, there’s still a lot you can do. Here’s a short (and definitely not exhaustive list) of things you can do.

  3. Low Cable Rows

  4. Bent Over Single Arm Rows

  5. Ring Rows + Ring Push Ups

  6. Incline Push Ups

  7. Banded Pull Aparts

  8. Straight Arm Push Downs

  9. Tricep Push Downs

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