Shoulder Impingement: Why It Happens and How to Fix It
Shoulder impingement is one of the most common diagnoses I see, yet it's also one of the most misunderstood.
Many people have been told that something in their shoulder is being "pinched."
While that's not entirely wrong, it's also not the complete picture.
The reality is that shoulder impingement is often more of a movement problem than a structural problem.
And that's good news.
Because movement problems are something we can improve.
What is shoulder impingement?
The shoulder is one of the most mobile joints in the body.
That mobility is great when you're reaching overhead, lifting weights, throwing a ball, serving a tennis ball, or swinging a golf club.
The downside is that the shoulder relies heavily on coordination and stability.
When the muscles and joints around the shoulder stop working together efficiently, the tissues within the joint can become irritated.
This is often what people experience as shoulder impingement.
Common symptoms include:
Pain reaching overhead
Pain when lifting weights
Pain sleeping on the shoulder
Pain reaching behind your back
Reduced range of motion
Many patients initially think they've torn something because of how limiting the symptoms can feel.
Fortunately, that's often not the case.
What causes shoulder impingement?
There are several factors that can contribute.
Some of the most common include:
Rotator cuff weakness
Poor shoulder blade control
Limited thoracic spine mobility
Repetitive overhead activities
Poor movement mechanics
I see this frequently in golfers, pickleball players, tennis players, CrossFit athletes, and active adults throughout Scottsdale and Phoenix.
Often the shoulder itself isn't the only problem.
The upper back, shoulder blade, and surrounding musculature all play important roles.
What does the research say?
Research published in The British Journal of Sports Medicine and JOSPT has shown that exercise-based rehabilitation is highly effective for shoulder impingement and related shoulder pain conditions.
In many cases, outcomes from physical therapy are comparable to more invasive treatment options.
The key is addressing the underlying dysfunction instead of simply avoiding activities that hurt.
How I treat shoulder impingement
One of the first things I look at is how the shoulder is moving.
Where is mobility restricted?
What muscles aren't doing their job?
What movements are causing irritation?
Once we identify those factors, treatment becomes much more targeted.
Depending on the individual, treatment may include:
Dry needling
Joint mobilization
Soft tissue treatment
Thoracic spine mobility work
Rotator cuff strengthening
Scapular stabilization exercises
One of the most common things I find is stiffness within the shoulder joint itself.
When appropriate, I often perform more aggressive capsular mobilizations to help restore motion and reduce irritation.
We then reinforce that mobility through specific exercises and strengthening.
Because if we improve motion without improving control, the problem often comes right back.
Why rest alone usually doesn't work
Many people try resting their shoulder for weeks or months.
While this may temporarily reduce symptoms, it rarely addresses the root cause.
In fact, prolonged avoidance often leads to more weakness and less mobility.
That's why the goal isn't simply resting the shoulder.
The goal is improving the way it functions.
The bottom line
Shoulder impingement can be frustrating, but it's also one of the conditions that often responds extremely well to physical therapy.
At Modern Movement Physical Therapy in Scottsdale, I focus on identifying the movement limitations, mobility restrictions, and strength deficits contributing to the problem.
Once we address those factors, most people are able to return to the activities they enjoy with significantly less pain and better performance.
Because your shoulder wasn't designed to sit on the sidelines.
It was designed to move.
Take good care of your body, it's the only one you have.
Yours in health,
Dr. Michael Price