What is Shoulder Impingement Syndrome?


What is shoulder impingement syndrome?

Shoulder impingement syndrome usually presents as pain at the front of the shoulder. It is typically persistent pain and is made worse with certain exercises or posture.

There are several structures that come together in that area, they are: the biceps tendon, pectoral muscles, some of the rotator cuff tendons, the latissimus muscles, and we also have a capsule that surrounds the whole joint.

Impingement syndrome refers to the inflammation of one or some of these structures at the front of the shoulder. Typically this is caused by repetitive activities done with the front of the shoulder moving forward and in towards the body. This puts pressure on those structures and over time they become irritated and inflamed.

What can you do about impingement syndrome?

Typical palliative measures may make the symptoms calm down such as ice, rest, massage, or other anti-inflammatory techniques. These may help with the pain temporarily but it is important to get to the root cause of the problem. Usually the front of the shoulder is over worked and tight and the muscles of the back and rotator cuff are weak. When the back and rotator cuff muscles are weak, the front of the shoulder gets used more and repetitive use in this way will create inflammation and pain. It is important to work on strengthening the back (specifically the serratus, lattisimus, mid-trapezius and rhomboids), and the rotator cuff muscles on and underneath your shoulder blade. It is also important to improve the mobility of the upper part of your spine (thoracic spine) and your neck (cervical spine).

Treatment for shoulder impingement syndrome in the office is chiropractic adjustments to parts of the spine that need to be mobilized and of course the shoulder. I will also do some soft tissue work around the shoulder to help the tissues relax and get more range of motion in the shoulder joint itself. I follow that up with in office Pilates rehabilitation, as well as give you some at home exercises to do. Typical signs of shoulder impingement syndrome include pain at the front of the shoulder that is worse after activity and is also exacerbated by poor posture (i.e. sitting or standing with forward shoulders).

If you think you may have shoulder impingement syndrome please reach out or let me know at your next visit!

Dr. Tablak

Exercises for shoulder impingement syndrome


Rocket: Lay on your stomach with your arms long by your side. Lift your hands off of the mat and reach your fingers long towards your feet so you feel the muscles underneath your shoulder blades ( Latissimus muscles) activate. Draw your shoulder blades slightly toward one another so your chest is open then lift your upper back and hold the position for 30 seconds. You can rest for 30 seconds and repeat up to three times. Doing this once for 30 seconds a day can improve your mid back strength and posture.


Swan: for thoracic mobility. Push down on the roller and draw the roller in towards your body as you lift your upper back. Make sure to keep your abdominal muscles toned to take care of your lower back. Do 5-10x each day.


Rotator cuff exercise: do 3 sets of 10 3x per week

Juliet Tablak