Shoulder pain is one of the most common things we see in the clinic. While there can be so many different reasons why someone might have shoulder pain, one of the most common diagnoses given by doctors is something commonly known as “shoulder impingement”. What most people hear is that their rotator cuff, bursae, or other structures are getting “impinged” under the acromion and other surrounding structures, leading to the tendon getting worn out by the bone that is pinching it and subsequent pain. While this can make logical sense, our current understanding of the scientific evidence leads us to believe that it’s not that straightforward.

For example, one of the most common shoulder surgeries in the last 20 years has been the “subacromial decompression”, where they essentially remove the bone that pinches down on the tendon, which in theory should greatly reduce someone’s pain and improve their function. Unfortunately this is not the case. When compared to a sham placebo surgery where they did not actually repair/remove anything, the actual subacromial decompression surgery performed no better! That tells us that there must be other factors at play.

Another example ties into the studies that have shown similar amounts of “impingement” occurring in both shoulders, but only one being symptomatic. If the original impingement theory was accurate, we would likely expect to see pain in both shoulders. The main idea here is that there are likely other factors at play including but not limited to: your current/past training program, sleep, stress levels, biomechanics, social environment, and other things that your physical therapist can help identify. This opens the opportunity for many different ways that you can improve your shoulder pain, where the original “impingement” theory might lead you to believe that the only way to improve your symptoms/function is to surgically remove a piece of bone from your shoulder.

So, how exactly do we treat shoulder impingement (or perhaps better named non-specific rotator cuff related shoulder pain, subacromial pain syndrome, or really just shoulder pain)? While the process can be a bit complex, a good place to start is temporarily avoiding the movements/positions/activities that are aggravating for your shoulder and instead focusing on the exercises and movements that feel good, are meaningful to you, and that you enjoy. As your shoulder becomes less sensitive, you can gradually re-introduce those previously aggravating activities as you start to build up the capacity of your shoulder. Here are some common examples of exercises that can help improve your shoulder’s capacity over time and help reduce pain/improve function:

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If you’re a little overwhelmed with the options available when it comes to getting out of shoulder pain, frustrated with the lack of progress, or in need of a clear long-term solution to get back to the things you love - then we can help. Click here to schedule a free Discovery Visit with one of our Doctors of Physical Therapy, or reach out to us at anytime at (760) 301-6566 or at [email protected]