man holding his shoulder in pain

What To Avoid With Shoulder Impingement

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Shoulder impingement syndrome is very frustrating, especially when the pain seems to come and go. 

You never quite know when you’ll be greeted with a shot of severe pain. 

This article will outline the major things to avoid when you have shoulder impingement so you can stop exacerbating the pain and start feeling better. 

Disclaimer: This content is for educational purposes and is not medical advice. Read the full disclaimer.

What is shoulder impingement?

Shoulder impingement is one of the most common causes of shoulder pain. 

Under normal circumstances, the shoulder joint is guided through a variety of motions with precision, thanks to the coordination of several muscles.

Shoulder impingement describes a condition in which the supraspinatus tendon (one of the rotator cuff muscles) becomes impinged (or pinched) between the upper arm bone (humeral head) and the acromion of the scapula (shoulder blade).

This can occur due to a shift in the mechanics of the shoulder from overuse, muscle strength imbalance, other injuries outside of the shoulder region, poor posture, or fatigue.

Shoulder impingement goes by a variety of names to describe the same injury. You might also hear it referred to as shoulder tendonitis, rotator cuff tendonitis, impingement syndrome, or even swimmer’s shoulder. 

Watch the video below for more insight into shoulder impingement.

Shoulder impingement symptoms

  • Pain in the shoulder, possibly radiating to the upper arm, shoulder blade, elbow, or wrist
  • Decreased range of motion or painful portions of your range of motion
  • Difficulty sleeping on the affected shoulder
  • Decreased strength or functional use of the arm due to pain

Shoulder impingement often starts as a dull ache at the top of the shoulder with reaching overhead, to the side, or behind the back. 

It can be easy to ignore at this stage, but this is one pain you shouldn’t try to work through.

In more severe cases, pain may radiate down the outside of the arm to the elbow or even the wrist. The pain may feel sharp at times, especially when moving too quickly into an aggravating range of motion. 

Pain may be present in small areas of range of motion or throughout a more extensive arc, ranging from mild to severe. 

Shoulder impingement can progress to a frozen shoulder if not treated. As a result, some people are at an increased risk of developing frozen shoulder

Related read: How To Relieve Shoulder Impingement Pain

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What to avoid with shoulder impingement

Here are some of the most common things to avoid that can worsen shoulder impingement.

Ignoring the pain

Ignoring shoulder pain in the early stages is pretty common. You may just think you slept wrong or overdid it, and it should go away in a few days.

But then you get busy, and before you know it, a few weeks or maybe even months have passed. That shoulder pain is still here and may get a little worse. 

If it’s been a few weeks and the pain doesn’t seem to be improving, it’s best to get it checked out before things get worse.  

The longer an orthopedic condition lingers without being addressed, the longer it takes to get better. You also run the risk of developing other pain in the neck and upper back due to compensation for the original issue. 

Intentionally pushing through the pain

Unfortunately, shoulder impingement pain isn’t the type of pain you can just work through and have it feel better. In fact, it typically gets worse when you try to push through the pain. 

Try to identify which movement causes the pain and modify your activities and movements to avoid constantly exacerbating your pain until you can get it evaluated. 

Intentionally pushing through the pain could lead to a rotator cuff tear over time.

Don’t stop using your arm altogether

Sometimes people think that if they stop using their arm altogether, the pain will disappear. While this may help you feel better in the short term, it tends to make things more difficult in the long run.

When you stop moving your shoulder through normal range of motion, things start to get stiff, and your comfortable range of motion can actually start to decrease. 

This isn’t just limited to the shoulder. A lack of movement is likely to yield neck and upper back stiffness as well. 

This is common when people begin to develop frozen shoulder and gradually lose shoulder motion. 

Related read: Shoulder Impingement vs. Frozen Shoulder

Sleeping on the affected arm

Getting a good night’s rest is a difficult feat when you have shoulder pain. Sleeping on your painful side often increases your pain and interrupts your sleep. 

If it’s possible, avoid sleeping on the affected side and use plenty of pillows to support your body in a comfortable position.

The Medcline Shoulder Relief System is a wedge and pillow combined with space to relieve shoulder pain and pressure while sleeping.

Don’t miss this article for practical tips on how to sleep with shoulder pain.

Certain exercises

Maintaining good shoulder strength can help prevent injury. But certain exercises can compress the rotator cuff (specifically the supraspinatus muscle) and cause or worsen an existing injury. 

To be fair, almost any upper body exercise can be harmful if performed incorrectly. Proper form is essential in keeping the rotator cuff healthy. 

It’s never as simple as labeling exercises “good” or “bad.”

Whether an exercise is appropriate (or not) for you depends on many factors, such as your fitness level, current injuries, medical conditions, goals, job, or sport-specific requirements. 

Modifying movements to avoid constant exacerbation is a big part of getting better fast. However, blindly labeling exercises as good or bad is a disservice and means nothing without context. 

Here’s a quick list of some exercises that are most likely to aggravate a rotator cuff injury that you should approach with caution.

To learn more about why each of these can be problematic, read 8 Exercises To Avoid When You Have A Rotator Cuff Injury.

  • Lateral raises
  • Upright rows
  • Triceps dips
  • Lat pulldowns behind the head
  • Lap swimming
  • Overhead movements with weights
  • Overhead throwing or serving sports

How to fix shoulder impingement pain

We’ve spent a lot of time on what not to do. Here are some things you can do to take an active role in fixing your shoulder impingement and getting the right treatment faster. 

  • DO get evaluated to determine the cause of your pain and set you up with the proper exercise program for you.
  • DO pay attention to your symptoms so you can articulate them to your health care providers to receive a more specific treatment.
  • DO learn about your shoulder problem so you can better understand safe ways to move and avoid exacerbations.
  • DO be consistent with your prescribed home program.
  • DO speak up and problem solve with your healthcare providers when something isn’t working.
  • DO manage your expectations for healing and celebrate small wins toward getting back to normal.

When to see a doctor

In general, it’s best not to ignore symptoms. Typically, orthopedic pain follows a pattern of being worse with certain movements.

If the pain is constant or doesn’t seem to follow a predictable pattern, don’t delay in seeing your doctor. Occasionally, shoulder pain can be referred from an internal issue (such as an internal organ).

Physical therapy is an excellent conservative option for shoulder impingement pain.

Shoulder mechanics can be affected by several areas. Physical therapy can help evaluate your overall movement and mobility to restore proper joint motion, strength, and use of your shoulder.

Depending on your insurance and the state you live in, you may be able to take advantage of direct access, meaning you can be evaluated by a physical therapist before seeing your doctor.

This allows you to start getting treatment earlier and possibly heal faster by bypassing wait times for a doctor’s appointment with an orthopedist or sports medicine physician.

If you’d like to see a doctor quickly, you can always start with your primary care doctor before progressing to a shoulder specialist.

Ask your local physical therapy clinic if you’re eligible for direct access.

Read this article to learn more about how to prepare for your first physical therapy appointment and how you can download the free checklist.

Wrapping up

Shoulder impingement pain is one of the most common complaints of shoulder pain. Physical therapy can be very successful at treating impingement syndrome.

If you’re having shoulder pain, don’t ignore your symptoms. Get evaluated by a physical therapist to get on the right track to healing. 

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