Shoulder impingement exercises

Shoulder impingement, now more often called subacromial pain syndrome, describes pain coming from the structures in the narrow space under the tip of the shoulder blade: the rotator cuff tendons and a small fluid-filled cushion called a bursa. The pain shows up as the arm is lifted towards or above shoulder height, or reached across the body.

The old explanation was that bone was pinching the tendon, and that idea has largely been set aside. It is now understood mainly as tendon and bursa that have been overloaded and become sensitive, usually after a change in overhead activity - a new job, a decorating spree, a block of swimming or throwing, or a return to the gym after time away.

Day to day it shows up as a painful arc: comfortable at the bottom of the movement, sore through the middle of the lift, often easier again at the very top. Reaching into the back seat of a car, washing hair, hanging out laundry and lying on that side at night are the usual complaints. The arm feels weak mostly because it hurts, not because anything has given way.

It is uncomfortable rather than harmful and it responds well to exercise, which is why loading is recommended long before injections or surgery. Most people improve noticeably over 6 to 12 weeks and keep building for a few months after that. This programme calms the painful arc first, then strengthens the rotator cuff and the muscles that steer the shoulder blade so the arm moves more efficiently, and finally rebuilds your tolerance for overhead work.

Who this programme is for

Adults with a painful arc of movement when lifting the arm, worse with overhead or reaching tasks, and no significant injury. If the arm suddenly became weak after a fall or heavy pull, get it checked for a cuff tear first.