Shoulder impingement is one of the most common causes of shoulder pain, accounting for up to 65 percent of all shoulder complaints seen in clinical settings. If reaching overhead, sleeping on your side, or putting on a jacket causes a sharp or aching pain in your shoulder, there is a good chance you are dealing with impingement. The good news is that physical therapy is highly effective for this condition — most patients avoid surgery entirely with the right treatment approach.
What Is Shoulder Impingement?
Shoulder impingement occurs when the tendons of the rotator cuff and the bursa (a fluid-filled sac that reduces friction) get pinched between the ball of the humerus and the bony arch above it called the acromion. Every time you raise your arm, these structures must pass through a narrow space called the subacromial space. When that space is reduced — whether from swelling, poor mechanics, or structural factors — the tendons get compressed and irritated.
Over time, repeated impingement causes the rotator cuff tendons to become inflamed (tendinitis), the bursa to swell (bursitis), and eventually the tendon fibers to degenerate and weaken (tendinopathy). If left untreated, this progressive breakdown can lead to rotator cuff tears.
Why It Happens
In most cases, shoulder impingement is not caused by a single event but by a combination of factors that develop over time. Rotator cuff weakness allows the humeral head to migrate upward during arm elevation, reducing the subacromial space. Scapular dyskinesis — poor movement of the shoulder blade — prevents the acromion from tilting out of the way during overhead reaching. Postural factors like rounded shoulders and forward head position further narrow the available space. Repetitive overhead activities in sports and occupations accelerate the degenerative process.
How Physical Therapy Resolves Impingement
Effective treatment addresses the mechanical causes of impingement rather than just treating the symptoms. Our approach at Kinito Physical Therapy includes rotator cuff strengthening to improve dynamic centering of the humeral head, scapular stabilization exercises to restore normal shoulder blade mechanics, thoracic spine mobility work to allow proper overhead reach, postural correction to optimize resting shoulder alignment, and manual therapy to reduce pain and restore joint mobility.
Most patients notice significant improvement within 4 to 6 weeks of starting a structured program, with full resolution typically occurring within 8 to 12 weeks.
Exercises You Can Start Today
Doorway Pec Stretch: Stand in a doorway with your arm at 90 degrees against the frame. Step through gently until you feel a stretch across the front of your chest. Hold 30 seconds, repeat 3 times per side. This opens the anterior shoulder and combats the rounded posture that contributes to impingement.
Side-Lying External Rotation: Lie on your uninvolved side with the affected arm on top. Keeping your elbow pinned to your side, rotate your forearm toward the ceiling against a light weight or resistance band. 3 sets of 15 repetitions. This directly strengthens the external rotators that center the humeral head.
Get Lasting Relief
Do not let shoulder impingement limit your life. With proper physical therapy, most patients achieve full, pain-free function without surgery. Contact Kinito Physical Therapy or call (405) 633-0783 to schedule your shoulder evaluation.
Disclaimer: The information provided in this blog post is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment.
