Chances are if you know what this is, you (or a client) have either been diagnosed with this or you’ve self-diagnosed yourself with it. (Wink wink). Shoulder impingement is just what it sounds like; there’s some pinching going on in your shoulder that’s beginning to damage your tissues and cause pain. It’s important to understand that it is very general diagnosis. It’s just like a cause of death as ‘old age’. It doesn’t really give you all the facts or causes. One does not spontaneously just ‘contract’ impingement. They earn it. To understand what it is, and what one can do to get over it, let’s cover some of the basics.
When we move our shoulders (or any part of our body for that matter) we have an ideal alignment. This ideal alignment allows for maximal flexibility and minimal stress on the body. You could also have very poor alignment of your rib cage and shoulder. This would add a great deal of stress on the shoulder and limit your flexibility. Let’s do a little self test to demonstrate what I’m talking about.
RIBCAGE SLUMP EXERCISE:
I want you to slump forward in your chair (PICTURE OF SLUMP POSTURE). Now abduct your arms out to the side as high as you possibly can. Not too far right?
Sit Up Upright with Your shoulder’s in a neutral position (PICTURED). Now abduct your arms as far as your can.
MUCH easier right??? What this demonstrates is how the posture of your body impacts the movement of your shoulder. If your rib cage, torso and spine don’t have ideal posture, it will lead to minimal spacing and increased stress on the area.
There are multiple different ‘impingements’ that can occur within the shoulder. The impinging symptoms of pain and pinching normally accompanies limited range of motion, strength and at times radiating pain. If you have any pain at all within your shoulder, it’s actually safe to assume to that you’ve got some impingement going on. Bad impingement can lead to more sinister conditions like rotator cuff tears, arthritis, degeneration, etc.
The bottom line is that when you move your shoulder, the structures rub together to create friction, irritation, inflammation and pain. There are many different possibilities on what specifically caused your issue. Contributing Factors to Shoulder Impingement are poor posture, and decreased upper torso/ribcage flexibility. The vast majority of us spend so much time sitting throughout our lives (even if we’re very young) that we don’t extend or rotate our upper torsos enough to maintain the ideal flexibility in the area. As a result, we lose that flexibility. Now, when we raise our arms overhead, because the upper torso won’t contribute any motion, all the movement and stress goes directly to our shoulders. It’s a recipe for disaster. Whenever I’m treating a shoulder injury the first thing I look at is the upper torso/ribcage flexibility and often I notice overly tight pectoral muscles. This creates an imbalance of muscles causing the posture of the shoulder and shoulder girdle to be altered, in a negative way.
What to Do:
To improve the balance of the postural muscles of the shoulder an shoulder girdle, one needs to regularly perform exercises that maintain the flexibility, strength and stability of the upper body. While there are specific exercises that one can perform while in pain (see course ‘Exercise Away Your Shoulder Pain’), one should perform 2 pulling resistance exercises for every pushing resistance exercise during regular fitness maintenance. You can include some of the following:
-Single Arm Rows
-Straight Arm Lat Pulldowns
How To Do It:
Now it’s not as simple as ‘perform these exercises and all will be fixed’. Your job is to re-train how your shoulders stabilize and control themselves. To accomplish that, you want to maintain tension throughout the exercises. I commonly see people releasing tension towards the end of the eccentric part of the movements. Specifically with these posture based movement, don’t release the tension. This will help with muscle hypertrophy as well as ‘time under tension’ is always a huge factor for muscle growth.
-3-5 sets of 10-25 reps.
-Using bands for these exercises is a great strategy to being able to get high reps while maintaining the tension throughout.
-these are particularly great to do as a workout finisher towards the ends of the workout when supporting large weight amounts is no longer a good idea
It’s important to note that these exercises should be performed in pain free ranges of motion. If you have pain while performing these, do not perform them. Instead consult your doctor or enroll in the class ‘Exercise Away Your Shoulder Pain’. Good luck to you and please leave a comment if you’re struggling with shoulder issues.
Dr. Scott Hoar
Owner, Mobility 4 Life Chiropractic and Sports Medicine