Shoulder Impingement: Causes, Symptoms, and the Exercises That Actually Help
- Baytide Health
- Dec 6, 2025
- 3 min read
Shoulder pain that slowly creeps in — especially with reaching, lifting, or sleeping on your side — is often blamed on “getting older” or “overdoing it.” But one of the most common causes of this pain is something much more specific: shoulder impingement.
Understanding what shoulder impingement is (and what it can turn into if ignored) is the key to protecting your rotator cuff and keeping your shoulder strong for years to come.
What Is Shoulder Impingement?
Shoulder impingement happens when the tendons of your rotator cuff get squeezed or “impinged” under a small bony arch at the top of your shoulder called the acromion.
Every time you lift your arm, these tendons and the bursa (a small fluid-filled sac) need space to glide. When that space becomes too tight — because of inflammation, poor mechanics, or muscle imbalance — those tissues get irritated, painful, and swollen.
Over time, the cycle repeats: Swelling → Less space → More irritation → More swelling.
The Shoulder Anatomy You Actually Need to Know
The shoulder is naturally one of the most mobile joints in the body, and that mobility comes from several key structures working together:
Rotator cuff muscles: A group of four small but essential muscles that stabilize the ball of your shoulder joint.
The acromion: A bony “roof” that sits above the rotator cuff.
Your scapula (shoulder blade): The foundation of all shoulder movement. When it moves well, your shoulder moves well.
If the shoulder blade doesn’t rotate upward correctly, if the rotator cuff is weak, or if the space under the acromion narrows because of inflammation or posture, the tendons get pinched.
That’s shoulder impingement in simplest terms:Too little space + too much friction = pain.
Can Shoulder Impingement Cause Permanent Damage?
Yes — if ignored.
Chronic impingement places constant pressure and friction on the rotator cuff tendons. Over months or years, this can lead to:
Tendon thickening
Tendon degeneration
Rotator cuff tears
Many rotator cuff tears start as untreated impingement. Early intervention makes a huge difference in preventing long-term damage.
What Should You Do About It?
Addressing shoulder impingement early is essential. Treatment focuses on:
Reducing inflammation
Improving shoulder mechanics
Strengthening the stabilizing muscles
Restoring healthy movement without pain
This is where targeted exercises and expert guidance matter. Random stretching or “shoulder workouts” won’t address the underlying dysfunction — especially if the scapula isn’t moving well or if certain muscles are compensating.
Why Shoulder Mechanics and Scapular Stability Matter
Your rotator cuff cannot do its job if the foundation (your shoulder blade) is unstable. When the scapula doesn’t rotate upward, tilt, or glide correctly, the rotator cuff works overtime — and impingement becomes almost inevitable.
Improving mechanics means training:
Scapular stabilizers
Postural muscles
Rotator cuff strength
Correct arm movement patterns
This combination restores space in the joint and gives the rotator cuff room to glide again.
Five Foundational Exercises for Shoulder Impingement
These exercises help promote better mechanics, improve scapular stability, and strengthen the rotator cuff. Pain should never exceed mild discomfort during or after these.
1. Prone “I”
Lie face-down with arms back by your sides. Lift your arms straight up toward the ceiling, squeezing your shoulder blades gently down and in. This targets the lower traps to help with scapular upward rotation.
2. Prone Row
From the same position, bend your elbows and row toward your ribs, keeping your shoulder blades pulling back and down. Great for mid-trap and rhomboid strength.
3. Scapular Retractions (Standing or Seated)
Gently pull your shoulder blades back without shrugging. This wakes up postural muscles essential for creating space in the shoulder joint.
4. External Rotation with a Band
Keep your elbow at your side and rotate your forearm outward. This isolates the rotator cuff — specifically the infraspinatus.
5. Serratus Wall Slides
With forearms on a wall, slide upward while gently pressing into the wall. This helps activate the serratus anterior, a key muscle in healthy scapular motion.
How Working With a Therapist Helps
Shoulder impingement is rarely just a “weak muscle” or “tight tendon.” It’s usually a combination of postural habits, muscle imbalances, movement patterns, and mobility restrictions — all unique to you.
A therapist can:
Identify your specific weak links
Correct compensations you may not notice
Customize exercises to fit your body and your goals
Monitor progress and safely progress your program
Teach proper mechanics to prevent recurrence
The right program does more than relieve pain — it helps you move better, feel stronger, and protect your rotator cuff long-term.
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