7 Exercises to Relieve Painful Shoulder Impingement, Restore Good Posture, and Prevent a Rotator Cuff Tear

Shoulder impingement accounts for up to 65 percent of shoulder disorders. These physical therapy exercises can reduce pain and prevent rotator cuff tears.

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By Kevin Shelley

10/27/2023Updated: 10/27/2023

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Shoulder impingement is the most common shoulder disorder, accounting for up to 65 percent of all shoulder pain complaints. Impingement typically results in a reduced range of motion and shoulder function, often interfering with sleep and the ability to perform basic everyday functions.

The good news is that with some simple shoulder exercises, you can significantly reduce your pain and restore your shoulder function.

Shoulder Impingement Syndrome

An impingement arises from a narrowing of the subacromial space in the shoulder that leads to tissues being “impinged” or pinched between shoulder bones during movement. Left unaddressed, shoulder impingement can contribute to a rotator cuff tear.

(VectorMine/Shutterstock) — VectorMine/Shutterstock

Anatomy of the Shoulder

Three bones contribute to the shoulder joint:

The humerus is the long bone in the upper arm that runs from the shoulder to the elbow.
The scapula, also known as the shoulder blade, connects the humerus with the clavicle.
The clavicle, or collarbone, connects the shoulder blade to the breastbone.

The shoulder is highly mobile, and its stability comes from more than just the bones. Instead, a fibrous shoulder capsule, various ligaments, and the rotator cuff muscles work together to lend stability.

Your rotator cuff consists of a group of four muscles that originate on the shoulder blade (scapula) and attach as a “cuff’ onto your upper arm (humerus). The muscle we will focus on for this article is the supraspinatus.

There are two shoulder joints:

The glenohumeral joint is the ball-and-socket junction at the top of the arm bone and the shoulder blade (scapula) socket. The scapula connects with the humerus at the glenohumeral joint.
The acromioclavicular (AC) joint arches above the glenohumeral joint. The joint is formed with the acromion (the top outer edge of your scapula) and your collarbone.

Where the AC joint forms a sort of bony “roof” over the supraspinatus, the top of the humerus forms the “floor,” leaving its soft tissues sandwiched between two hard, moving, bony surfaces, and it’s here that problems can start.

(Alila Medical Media/Shutterstock) — Alila Medical Media/Shutterstock

Common Causes of Impingement

Your rotator cuff helps you raise your arm overhead and allows you to rotate it both toward and away from your body. It sits in a small space between two bones, the acromion and the humerus, making it more susceptible to being “impinged.”

Poor Posture

There are several structural reasons why the subacromial space can narrow and cause impingement, but a common and preventable contributor is poor posture.

Rebecca Gold, an occupational therapist for over 33 years specializing in hand and shoulder rehabilitation, told The Epoch Times, “When the scapula is in the proper position, there’s plenty of room for tendons to glide like they’re supposed to without getting pinched.”

Poor posture changes that. As the shoulders come forward, the space between the “roof” and the “floor” of the shoulder complexes reduces, and this sets the stage for impingement of the supraspinatus muscles. “Some people run into impingement when they unintentionally assume a shoulder-forward posture and/or the scapula is somewhat elevated and protracted, which enables the supraspinatus tendon to get pinched between the head of the humerus (floor) and the acromion process (roof),” Ms. Gold explained.

Repetitive Movements

Over time, repetitive movements can contribute to continued pinching that irritates the supraspinatus muscle. Overhead reaching can place the most pressure on the tendon. Pain experienced with overhead reaching can be a sign that irritated supraspinatus tendons are crying out for help and can also indicate that a supraspinatus tear may be imminent.

Shoulder Impingement Exercises

Ms. Gold recommends the following exercises to restore good posture, which may help you avoid repetitive shoulder impingement and the risk of a rotator cuff tear.

1. Seated Scapular Retraction

The seated scapular retraction exercise helps bring the shoulders out of forward slumping and back into normal alignment, decreasing the risk of impingement.

(Chung I Ho/The Epoch Times) — Chung I Ho/The Epoch Times

Step 1: Sit or stand in an upright position while keeping your head straight up. Keep your arms by your side the entire time.
Step 2: Slowly bring your shoulders straight back and squeeze your shoulder blades together while also pushing your shoulders down (scapular depression). Hold for three seconds.
Step 3: Slowly bring your shoulders back forward. Don’t jut your chin when you bring your shoulders back.
Step 4: Repeat this movement 12 times per set and perform three total sets.

2. Resisted Shoulder External Rotation/Scapular Retraction

This exercise dials in on the back muscles. Strengthening these muscles can also assist in correcting bad posture.

Step 1: Stand with your arms to your sides, your elbows bent approximately 90 degrees, and your hands holding a resistance band.
Step 2: Slowly rotate your forearms out to the side, away from your body. At the same time, hold your shoulder blades down and squeeze them together. Hold for three seconds before slowly returning your hands together.
Step 3: Perform 12 repetitions per set and three sets in total.

Be sure to control the resistance band when bringing your hands back together. Slowing your pace of movement can help with this. Be diligent about maintaining your form.

3. Standing Resisted Shoulder Row

Step 1: Stand with arms straight ahead at shoulder level, holding the ends of a resistance band that is anchored in the middle to a stable surface. You can also use two different bands, one for each arm, if preferred.
Step 2: Keeping your arms by your side, slowly pull toward you until you can’t move your elbows any further back. Be sure to keep your shoulders down; do not shrug them during movement. Your hands should start at shoulder level but end at belly button level.
Step 3: Immediately bring your arms back into the starting position.
Step 4: Repeat this movement 10 times per set and perform three sets.

4. Standing Resisted Shoulder Extension

This exercise starts like the resisted shoulder row, but instead of elbow flexion, it focuses all muscular exertion on the shoulders and upper trunk.

Step 1: Start this exercise like the resisted shoulder row, with your arms straight ahead at shoulder level.
Step 2: Keeping your elbows straight, pull your hands down next to your hips while keeping your arms by your sides.
Step 3: Immediately move your hands back into the starting position.
Step 4: Take one second to move in both directions and perform 10 repetitions per set and three sets.

If you experience pain when bringing your arms straight out, only bring them up as high as you can, even if that means that they are in line with your hips and your arms are at a 45-degree angle.

5. Seated Shoulder Flexion Towel Slides

Seated shoulder flexion towel slides allow you to perform exercise in what is known as a gravity-eliminated position. Your shoulder does not need to carry the weight of the arm during this movement, and you can focus on the exercise without unnecessary provocation of pain.

Step 1: Sit facing a table. Place one hand on a towel on the table with your elbow straight out. Place your other hand on your leg to provide support for your back.
Step 2: Slide your hand forward on the table while sliding on the towel. Once you move your arm to approximately 90 degrees of shoulder flexion, bring it back to the starting position while pushing down on the towel.
Step 3: Perform 10 repetitions per set and three sets.

6. Seated Shoulder Abduction Towel Slides

This exercise is great to do immediately following the seated shoulder flexion towel slides since it is somewhat similar.

Step 1: Sit with your side to a table, approximately a foot away.
Step 2: Place your hand on a towel with your elbow straight.
Step 3: Slowly slide your arm out to the side until your shoulder is at approximately 90 degrees.
Step 4: Immediately move back to the starting position while continuing to press down on the towel.
Step 5: Perform 10 repetitions per set and three sets.

7. Seated Shoulder Passive Range of Motion, External Rotation

Perform this exercise after the seated shoulder abduction since you’ll be in a similar position. Note that this is a passive range of motion exercise that allows you to work on shoulder range without actually having to use the muscles of the shoulder.

Step 1: Sit close to a table facing sideways.
Step 2: Place your forearm on the table while making sure that your elbow is also in contact; keep your elbow bent.
Step 3: Slowly lean straight forward while keeping your arm on the table.
Step 4: Stop when your head is level with your hand. Slowly lift your head and return to the starting position.
Step 5: Perform 10 repetitions per set and three sets.

Your arm is merely going along for the ride. Bending forward with your arm on the table allows you to move your shoulder into and out of external rotation passively.

These exercises can help decrease your risk of experiencing shoulder impingement and may prevent a future rotator cuff tear. Feel free to customize these exercises to fit your needs.

For best results, do these exercises at least three times per week or preferably every day.

*If you have health or mobility issues that may present problems, consult your physician before commencing exercise activity.

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.