Shoulder impingement can be a debilitating condition that affects many individuals, particularly those involved in physical activities or professions that require repetitive arm movements. It occurs when the tendons of the rotator cuff and the bursa within the shoulder joint become compressed or irritated.
While exercise is crucial for maintaining overall health and strength, certain exercises can exacerbate shoulder impingement symptoms and hinder the healing process.
In this comprehensive guide, we will explore the exercises to avoid, the reasons behind their detrimental effects, and alternative exercises to include in your workout routine.
Anatomy of the Shoulder
Before diving into the exercises, it’s important to understand the anatomy of the shoulder joint. The shoulder joint is a ball-and-socket joint comprising the humerus (upper arm bone) and the scapula (shoulder blade).
The rotator cuff, a group of muscles and tendons, provides stability and allows for various arm movements. The acromion, a bony projection from the scapula, can impinge on the tendons and bursa, causing shoulder impingement.
Overview of the Shoulder Joint
The shoulder joint consists of the glenoid fossa, a shallow socket on the scapula, and the rounded head of the humerus. This structure allows for a wide range of motion but also makes the shoulder vulnerable to impingement.
Types of Shoulder Impingement
There are four primary types of shoulder impingement:
- anterior acromial impingement
- posterosuperior glenoid rim impingement
- subcoracoid impingement and
- suprascapular nerve (at the spinoglenoid notch) impingement.
Causes of Shoulder Impingement
Shoulder impingement can result from a variety of factors. Overuse or repetitive motions, such as those encountered in sports like swimming or throwing, can contribute to impingement.
Poor posture, muscle imbalances, and weak rotator cuff muscles can also increase the risk. It’s essential to identify the causes to effectively prevent and manage shoulder impingement.
Symptoms of Shoulder Impingement
Recognizing the symptoms of shoulder impingement is crucial for early detection and treatment. Common symptoms include pain when lifting the arm, pain during overhead activities, weakness in the affected shoulder, and a clicking or popping sensation. It’s important to be aware of these symptoms and seek medical help if they persist or worsen.
Common Symptoms
Pain is the primary symptom of shoulder impingement. It is often felt in the front or side of the shoulder and may radiate down the arm. Pain can be sharp, aching, or throbbing, and it typically worsens with activities that involve raising the arm or reaching overhead.
Signs To Look Out For
Aside from pain, there are several signs that may indicate shoulder impingement. These include limited range of motion, difficulty reaching behind the back, muscle weakness, and the sensation of the shoulder “catching” or “grinding” during movement. If you experience any of these signs, it’s essential to consult a healthcare professional for an accurate diagnosis.
When To Seek Medical Help
If you have persistent or severe shoulder pain, or if your symptoms significantly impact your daily activities and quality of life, it is crucial to seek medical help. A healthcare professional can provide a proper diagnosis and recommend appropriate treatment options, including physical therapy or, in some cases, surgical intervention.
Exercises To Avoid With Shoulder Impingement
To prevent further aggravation of shoulder impingement, certain exercises should be avoided. These exercises typically involve overhead pressing movements, bench pressing exercises, pulling exercises, and other movements that place excessive stress on the shoulder joint.
Overview of Exercises To Avoid
1. Overhead Pressing Exercises:
- Dumbbell Overhead Press
- Barbell Overhead Press
- Military Press
2. Bench Pressing Exercises
- Flat Bench Press
- Incline Bench Press
- Decline Bench Press
3. Pulling Exercises
- Pull-Ups
- Lat Pulldowns
- Rows
4. Other Exercises To Avoid
- Lateral Raises
- Upright Rows
- Behind-the-Neck Exercises
Why These Exercises Should Be Avoided
These exercises can exacerbate shoulder impingement symptoms such as pain because they require excessive shoulder elevation, internal rotation, or horizontal abduction. These movements compress the tendons and bursa within the shoulder joint, leading to increased pain and potential further injury.
How To Modify Exercises To Avoid Impingement
If you still wish to engage in exercises similar to the ones mentioned above, it’s crucial to modify them to prevent impingement. This can be achieved by reducing the range of motion, lowering the weight used, or adjusting the body positioning. Consulting with a qualified fitness professional or physical therapist can provide you with specific modifications tailored to your condition.
Overhead Pressing Exercises
Overhead pressing exercises, such as the Dumbbell Overhead Press, Barbell Overhead Press, and Military Press, should be avoided if you have shoulder impingement. These exercises place significant stress on the shoulder joint, exacerbating impingement symptoms.
Dumbbell Overhead Press
The Dumbbell Overhead Press involves lifting dumbbells from shoulder height to an overhead position. This movement requires excessive shoulder elevation and can worsen impingement symptoms.
Barbell Overhead Press
Similar to the Dumbbell Overhead Press, the Barbell Overhead Press involves lifting a barbell from shoulder height to an overhead position. The weight of the barbell, combined with the shoulder elevation, increases the risk of impingement.
Military Press
The Military Press is a weightlifting exercise that involves pressing a barbell from shoulder height to an overhead position while standing. The overhead position and the wide grip used in this exercise can place excessive stress on the shoulder joint, aggravating impingement symptoms.
Bench Pressing Exercises
Bench pressing exercises, including the Flat Bench Press, Incline Bench Press, and Decline Bench Press, should be avoided with shoulder impingement. These exercises require shoulder extension and horizontal abduction, which can compress the structures within the shoulder joint.
Flat Bench Press
The Flat Bench Press involves lying flat on a bench and pressing a barbell or dumbbells upward while keeping the elbows at a 90-degree angle. This exercise places significant stress on the shoulders, especially when using heavy weights, potentially exacerbating impingement symptoms.
Incline Bench Press
The Incline Bench Press is performed on an inclined bench, targeting the upper chest muscles. While this exercise primarily focuses on the chest, it still places stress on the shoulders, making it problematic for individuals with shoulder impingement.
Decline Bench Press
The Decline Bench Press involves lying on a decline bench and pressing a barbell or dumbbells upward. This exercise primarily targets the lower chest muscles but can still strain the shoulders and worsen impingement symptoms.
Pulling Exercises
Pulling exercises, such as Pull-Ups, Lat Pulldowns, and Rows, can also aggravate shoulder impingement. These exercises require shoulder extension and internal rotation, which can compress the tendons and bursa within the shoulder joint.
Pull-Ups
Pull-Ups involve gripping a bar and pulling your body upward until the chin reaches or clears the bar. This movement requires shoulder extension and can lead to impingement when performed with improper technique or when the shoulder joint is already compromised.
Lat Pulldowns
Lat Pulldowns target the latissimus dorsi muscles by pulling a bar down in front of the body. The excessive shoulder extension and internal rotation involved in this exercise can worsen impingement symptoms.
Rows
Rows, such as Bent-Over Rows or Seated Rows, involve pulling weights toward the body while keeping the back straight. While rows primarily target the back muscles, they also require shoulder extension and internal rotation, potentially exacerbating shoulder impingement.
Other Exercises To Avoid
Aside from the exercises mentioned above, certain movements should be avoided if you have shoulder impingement.
Lateral Raises
Lateral Raises involve lifting weights out to the sides of the body, targeting the deltoid muscles. While this exercise is commonly used to strengthen the shoulders, it can exacerbate impingement symptoms due to the excessive abduction and elevation of the arms.
Upright Rows
Upright Rows involve pulling a barbell or dumbbells upward towards the chin while keeping the elbows higher than the wrists. This exercise can cause impingement due to the internal rotation and elevation of the shoulders.
Behind-the-Neck Exercises
Exercises that involve lifting weights or performing movements behind the neck, such as the Behind-the-Neck Press, can increase the risk of shoulder impingement. These exercises put the shoulder joint in a vulnerable position, potentially causing further damage and pain.
Exercises To Include in Your Workout
While certain exercises should be avoided, there are still plenty of effective rotator cuff exercises that can be incorporated into your workout routine, even with shoulder impingement. These exercises focus on shoulder blade stabilization, rotator cuff strengthening, and stretching.
Overview of Exercises To Include
These exercises help improve shoulder mechanics, strengthen the surrounding muscles, and promote flexibility, all of which contribute to the overall health and function of the shoulder joint. Incorporating these exercises can aid in reducing impingement symptoms and preventing further injury.
How To Modify Exercises To Prevent Impingement
When performing these exercises, it’s important to focus on proper form and range of motion. Start with lighter weights or resistance bands and gradually increase intensity as tolerated. Listen to your body and modify the exercises as necessary to avoid pain or discomfort. Consulting with a qualified fitness professional or physical therapist can provide additional guidance on modifying exercises for your specific condition.
Shoulder Blade Stabilization Exercises
Shoulder blade stabilization exercises help improve the stability and positioning of the shoulder blades, which is essential for proper shoulder mechanics and reducing impingement risk.
Wall Slides
Wall Slides involve standing with the back against a wall and slowly sliding the arms up and down the wall while keeping the elbows, wrists, and back in contact with the wall. This exercise strengthens the muscles that control scapular movement, promoting optimal shoulder mechanics.
Scapular Push-Ups
Scapular Push-Ups are performed in a push-up position, with the focus on protracting and retracting the shoulder blades. This exercise targets the muscles responsible for scapular stability and can enhance shoulder function while minimizing impingement risk.
Prone T
Prone T is performed lying face down on a bench or mat with arms extended out to the sides, forming a “T” shape. By engaging the muscles of the upper back and shoulder blades, this exercise promotes scapular stability and proper shoulder mechanics.
Prone Y
Prone Y is similar to Prone T but with the arms extended at a 45-degree angle above the head, forming a “Y” shape. This exercise targets the muscles responsible for upward rotation of the scapula, enhancing shoulder stability and reducing impingement risk.
Rotator Cuff Strengthening Exercises
Strengthening the rotator cuff muscles is crucial for maintaining shoulder stability and preventing impingement. These exercises target the four rotator cuff muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis.
Internal Rotation
Internal Rotation exercises involve using a resistance band or cable machine to rotate the arm inward towards the body. This exercise targets the subscapularis muscle, which plays a significant role in shoulder stability.
External Rotation
External Rotation exercises focus on the external rotation of the arm away from the body using a resistance band or cable machine. This targets the infraspinatus and teres minor muscles, strengthening the posterior aspect of the shoulder.
Full-Can Exercise
The Full-Can Exercise is performed by holding weights or resistance bands with the thumbs pointing upward and lifting the arms to shoulder height. This exercise targets the supraspinatus muscle, which is commonly involved in impingement.
Side-Lying External Rotation
Side-Lying External Rotation is performed lying on the unaffected side with the arm at a 90-degree angle and the elbow against the side. By externally rotating the arm away from the body, this exercise engages the external rotator muscles and promotes shoulder stability.
Stretching Exercises
Stretching exercises help maintain or improve shoulder flexibility, reducing the risk of impingement and promoting overall shoulder health.
Doorway Stretch
The Doorway Stretch involves standing in a doorway and placing the forearm against the doorframe, then gently leaning forward to stretch the front of the shoulder. This stretch targets the pectoral muscles, which can become tight and contribute to impingement.
Cross-Body Stretch
Cross-Body Stretch is performed by bringing the affected arm across the body, using the opposite hand to gently pull the arm closer to the chest. This stretch targets the posterior shoulder and the muscles involved in internal rotation.
Sleeper Stretch
The Sleeper Stretch is done lying on the unaffected side with the affected arm positioned at 90 degrees in front of the body. Gently press the forearm downward, stretching the posterior shoulder and the internal rotator muscles.
Conclusion
When dealing with shoulder impingement, it’s crucial to avoid exercises that exacerbate symptoms and opt for exercises that promote shoulder stability, strength, and flexibility. By understanding the anatomy of the shoulder, recognizing the symptoms of impingement, and modifying exercises to prevent impingement, you can continue to maintain an active and healthy lifestyle while minimizing the risk of further injury.
Remember to consult with a healthcare professional or a qualified fitness professional to ensure the exercises you choose are suitable for your specific condition. By taking a proactive approach and incorporating the right exercises, you can navigate shoulder impingement and work towards optimal shoulder health.
