As the most mobile joint in your body, your shoulders take on quite the load during upper-body workouts and everyday tasks. They're constantly working to stabilize your arms, whether you're lifting weights, hauling groceries around or perfecting a yoga inversion.
But if you start feeling your shoulders pinch and grind while you press a weight overhead or shift into Downward-Facing Dog, it may be time to chat with your doctor. You may be experiencing shoulder impingement, which is treatable but requires close attention — and potentially a few sessions with a physical therapist.
What Is Shoulder Impingement?
Shoulder impingement originates in the rotator cuff, a group of muscles and tendons that surround your shoulder joint and assist with movement and stabilization, according to the American Academy of Orthopedic Surgeons.
Also known as subacromial impingement, shoulder impingement occurs when the rotator cuffs or bursa (fluid sacs in your shoulder) are compressed by your upper shoulder joint, explains Cameron Yuen, physical therapist at Bespoke Treatments in New York City.
"The physical impingement is a normal part of raising your arm overhead," Yuen says. "It is only when this movement is performed repetitively with poor range of motion and increased load that this impingement becomes painful." He adds that it's usually described as a painful pinch you feel when lifting your arms overhead or behind your back.
Generally, shoulder impingement will also lead to inflammation of the rotator cuff tendons and bursa, which can be pretty painful, Yuen says. If the condition goes untreated, it can cause the tendons to tear.
While it's best to consult a medical professional when you feel a pinch in your shoulder, there are a few exercises you can try to test whether you're dealing with impingement.
- First, reach your arm straight up overhead with your bicep by your ear. Do you feel any pain?
- Raise your arm in front of you to shoulder height, palm facing down. Bend your elbow to 90 degrees so your thumb is touching the opposite shoulder. Keep the elbow in place as you rotate the palm towards the ground. Does this cause pain?
If you feel pain in any of these tests, Yuen suggests consulting a doctor or physical therapist to properly diagnose your shoulder injury or pain. In the meantime, avoid the following three exercises.
3 Shoulder Impingement Exercises to Avoid
If you're experiencing pain when you exercise, you should temporarily step away from all movements and exercises that pinch your shoulders, Yuen says. While you don't need to stop exercising completely, avoiding painful upper-body exercises and movements is recommended. Here are three of the worst.
1. Behind-the-Neck Press
You might have seen bodybuilder types at the gym performing this overhead press variation, but it requires a range of motion that most people don't have, especially if you're experiencing shoulder impingement, Yuen explains.
"Pushing a load overhead into a range of motion you don't have is one of the primary paths to developing impingement pain," he says. "If performed repetitively, this movement will continue sensitizing an already-irritated rotator cuff tendon and bursa."
2. Triceps Dip
Although dips help strengthen your shoulders, chest and triceps all at once, the exercise puts you in extreme shoulder extension, which can often make impingement symptoms worse, Yuen says.
As with the behind-the-neck press, this movement also adds more stress on the rotator cuff tendon and bursa, but in a different way. "In this exercise, the shoulder is pinched when the arm is behind your body, likely irritating a different spot on the tendon," Yuen explains.
3. Upright Row
e upright row is a common exercise for the medial deltoids (your middle shoulder muscle), but it also puts the muscle in nearly the exact position used to test for impingement.
"This exercise almost maximally impinges the shoulder, so if your shoulder is painful, you will definitely want to remove these from your program," Yuen says. "If the tendons and bursa are already inflamed, this space is narrow and sensitive to begin with. Performing an upright row will likely make it worse."
What You Can Do Instead
Filling your workout routine with more lower-body strength and cardio exercises is the safest route to protect your shoulders. As Yuen mentioned, you'll want to stay away from all motions and exercises that further pinch the shoulder.
Lunges, squats and hip thrusts are just a few moves that make better alternatives as your shoulder heals.
- Start standing with feet at hip-width distance, arms at your sides.
- Step a few feet forward with your left foot.
- Lower into a lunge until both knees are bent to 90 degrees. Your back knee should hover just above the ground, and your front knee should be stacked over your ankle.
- Hold for a beat before pushing through your front foot to return to standing.
- Repeat on the other leg.
- Start standing, feet hip-width apart.
- Extend your arms out in front of you and slowly bend your knees as you push your hips back to squat down. Focus on lowering your body as if you were going to sit on a chair.
- Squat down until your thighs are parallel with the floor, or as low as you can go comfortably while maintaining good form. Your knees should be over your toes and your gaze should be straight ahead.
- Pause for a moment at the bottom of your squat.
- On an exhale, reverse the motion by pressing through your heels to return to standing. As you stand, lower your arms back to your sides.
Barbell Hip Thrust
- Start seated on the ground with the bottom of your shoulder blades on the edge of an exercise bench or box.
- Extend your legs out in front of you and roll a barbell up over your hips, placing a cushion underneath the bar for comfort if needed.
- Bend your knees and place your feet flat on the ground.
- Keeping your neck long, press into your heels and raise your hips off the ground, lifting the barbell up. As you bridge up, your neck and shoulders should move onto the bench.
- Pause here for a moment, then lower back down.
To modify this exercise, you can perform the move with no weight. Or, if you don't have a barbell, you can place a dumbbell or heavy water jug over your lap.
Treating and Preventing Shoulder Impingement
Shoulder impingement is an injury that usually occurs from poor shoulder mobility, Yuen says. As mentioned above, impingement is a normal part of raising your arms over your head, but a lack of mobility in your shoulders can cause this to become painful.
Good news: Treatment for shoulder impingement usually doesn't involve any invasive procedures. Bad news: You'll probably need to take a break from exercise. Usually, treating shoulder impingement takes a few months to heal and is a gradual process, according to the AAOS.
Alongside rest, your doctor may recommend anti-inflammatory medications or steroid injection, depending on the severity of your pain.
Usually, your doctor will also recommend physical therapy, which can help prevent future impingement, too. Working with a physical therapist will help improve the flexibility and mobility of your shoulder joints, per the AAOS. Then, your PT may put you on a shoulder strengthening program to help improve the rotator cuff muscles.
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