Shoulder impingement syndrome can sneak up on you, often starting as a dull ache or sharp pinch when you reach overhead, lie on your side, or lift something just a little too high. Over time, these "small" signs can start to add up, turning into persistent pain and reduced mobility. Eventually, it will start to affect your everyday tasks or workouts.

This condition is commonly rooted in poor posture, muscle imbalance, or repetitive shoulder motions. And because everyone moves differently, the way shoulder impingement shows up and how it should be treated can vary from person to person.

At Phoenix Rehab Singapore, we help you navigate the different types of shoulder pain. In this blog, we’ll look specifically into what shoulder impingement is, why it happens, and which physio-recommended exercises can help ease pain and restore shoulder function.

What Is Shoulder Impingement Syndrome

Shoulder impingement syndrome (SIS) occurs when the rotator cuff tendons or fluid-filled sacs in the subacromial space become irritated or compressed. This narrow space sits between the upper arm bone (humerus) and the acromion of the shoulder blade. If the rotator cuff tendons rub against the bone or surrounding structures during movement, it can lead to subacromial pain syndrome, more commonly known as shoulder impingement.

Let's make it a bit simpler and easier to digest.

SIS happens when the tendons in your shoulder or small fluid-filled sacs get squeezed or irritated. This squeezing usually happens when you lift your arm repeatedly or hold it in certain positions for a long time. Over time, the constant pressure causes pain, weakness, and limits how much you can move your shoulder comfortably.

Did You Know? Shoulder impingement syndrome often doesn’t start in the shoulder itself. Research shows that limited mobility or weakness in the thoracic spine (your upper back) can contribute significantly to shoulder impingement. When the thoracic spine is stiff or lacks extension, your shoulder blade (scapula) can’t rotate properly during arm movements. This forces the shoulder joint to work harder, increasing the risk of impingement.

So, addressing shoulder impingement often requires more than just focusing on the shoulder. It includes improving upper back mobility and posture, which can be a game-changer in preventing and managing this condition.

Examples of Shoulder Impingement

Subacromial impingement is a common type of shoulder impingement. It often involves the rotator cuff muscles and fluid-filled sacs known as bursae. Some people experience pain in the shoulder joint when performing repetitive overhead movements such as lifting, throwing, or swimming.

What Causes Shoulder Impingement

Shoulder impingement can develop due to several factors, including:

• Poor posture (forward head and rounded shoulders)
• Muscle imbalances in the rotator cuff and surrounding muscles
• Repetitive overhead movements that stress the shoulder joint
• Bone spurs or bony overgrowths that narrow the subacromial space
• Weak rotator cuff muscles and poor shoulder blade control

These factors can irritate the rotator cuff tendons, resulting in chronic pain and inflammation.

SIS is estimated to be a significant contributor to shoulder pain complaints in Singapore. It is often the most reported diagnosis for shoulder pain, accounting for 44-65% of all shoulder pain complaints. The good thing is, it is also recognised as a common and often treatable condition.

What You Can Do To Relieve Shoulder Impingement

While medical treatment might be needed for severe cases, many people can relieve pain and improve their range of motion through targeted exercises, self-care strategies, and physical therapy.

For instance, we apply certain principles of physiotherapy for frozen shoulder, which often focus on gentle stretching, improving joint mobility, and reducing stiffness - goals that are also essential for managing shoulder impingement. If you have SIS, you might notice that some of the exercises and mobility work used for frozen shoulder are also part of your treatment plan.

Self Massage

A simple self-massage with a lacrosse ball or tennis ball can help reduce pain in the muscles surrounding the affected shoulder. Place the ball between your upper back and a wall, and roll it gently to release tight areas. Focus on the back of the shoulder and upper back, which often become tight with poor posture.

Shoulder Impingement Exercises

Shoulder impingement exercises can improve flexibility, strengthen the rotator cuff and shoulder blade muscles, and help reposition the shoulder joint in a neutral position. By targeting the rotator cuff muscles, these exercises help reduce compression in the subacromial space and support pain-free movement.

10 Shoulder Impingement Exercises

One of the main reasons why exercises for shoulder impingement are a key part of your treatment plan is that, aside from recovery, they prevent the condition from recurring. Gentle range-of-motion exercises keep the joint moving and help decrease stiffness, while targeted exercises help the shoulder move properly and avoid pinching.

Note: It’s important to do the exercises properly. Poor technique can actually make the problem worse. Working with a physiotherapist or trained professional is recommended, especially in the early stages, to make sure you’re doing exercises that suit your condition.

Here are a few straightforward routines that are usually included in exercises for shoulder impingement.

1. Chair Bends

This exercise helps relieve tension and promote mobility in the shoulder joint.

Step 1: Sit in a sturdy chair.

Step 2: Lean forward, letting your affected arm hang down with the elbow bent slightly.

Step 3: Gently swing your arm in small circles or back and forth.

2. Crossed Arm Stretch

Also known as the crossover arm stretch, this stretch helps open up the back of the shoulder.

Step 1: Bring the affected arm across your chest at shoulder level.

Step 2: Hold the elbow with your opposite hand and gently pull it closer to your body.

Step 3: Hold for 20–30 seconds.

3. Door Frame Stretches (Chest and Shoulder)

This exercise opens up the chest and can improve posture.

Step 1: Position yourself in a doorway, arms raised to shoulder level and elbows bent.

Step 2: Place your forearms against the frame.

Step 3: Slowly step forward to stretch your chest and the front of your shoulders.

4. Floor Cobra

This exercise strengthens the muscles surrounding the shoulder blades and promotes good posture.

Step 1: Lie face down with your arms at your sides, palms facing the floor.

Step 2: Gently lift your chest off the ground while squeezing the shoulder blades together.

Step 3: Keep your neck in a neutral position.

Step 4: Hold for a few seconds, then slowly lower back down.

5. Floor Rotations (Internal and External)

This strengthens the rotator cuff muscles, which stabilise the shoulder joint.

Step 1: Lie on your back with your elbow bent at 90 degrees, holding a light weight.

Step 2: Rotate your arm slowly towards your stomach for internal rotation.

Step 3: Then, rotate your arm outwards for external rotation.

6. Long Pole Exercise

This helps gradually increase movement without straining the painful shoulder.

Step 1: Stand holding a long pole (like a broomstick) in front of you.

Step 2: With the pole held vertically, use your unaffected arm to guide the affected arm into a gentle range of motion.

7. Rotator Cuff Resistance Band Stretch

This exercise strengthens the rotator cuff and helps protect the shoulder joint during overhead movements.

Step 1: Secure a resistance band to a stable point.

Step 2: Grip the band while keeping your elbow bent to a right angle.

Step 3: Rotate your arm outward for external rotation.

Step 4: Repeat for 10–15 reps.

8. Shoulder Blade Retractions

Shoulder blade retractions can improve stability and reduce shoulder impingement.

Step 1: Stand or sit with your arms at your sides.

Step 2: Squeeze your shoulder blades together while keeping your head neutral and elbows bent.

Step 3: Hold for 5–10 seconds, then release.

9. Thoracic Foam Roller Stretch

This stretch targets the upper back and promotes good posture, which can reduce impingement symptoms:

Step 1: Lie on a foam roller placed horizontally under your upper back.

Step 2: Keep your hands behind your head.

Step 3: Gently extend your upper back over the roller.

10. Wall Slide

Here, focus on proper form and avoid lifting too high if experiencing pain.

Step 1: Stand facing a wall with your elbows bent and your forearms against the wall at shoulder height.

Step 2: Slowly slide your arms upward along the wall while squeezing the shoulder blades down and back.

Conclusion

With the right shoulder impingement syndrome exercises, you can relieve pain and restore proper function. Always start these exercises gently, using good form, and stop if you experience pain. Working with a physical therapist can ensure you’re using the right techniques and progressing at a good pace. In many cases, consistent physical therapy and strengthening the rotator cuff and shoulder blade muscles can help you move comfortably and get back to the activities you enjoy.