Shoulder Impingement Exercises (UPDATED 2020)

shoulder painImage courtesy of stockimages at FreeDigitalPhotos.net

What is Shoulder Impingement?

Shoulder Impingement is the compression of the following structures in the shoulder:

  • Subacromial bursa
  • Supraspinatus tendon

[See Video]

As a result – this can lead to painful conditions such as:

1. Subacromial bursitis

Let’s break it down into simpler terms:

a) Subacromial = “underneath the acromion”.

(The acromion is a bony process of the shoulder blade.)

b) Bursitis “inflammation of the bursa”.

(A bursa is a fluid-filled sac within the shoulder complex.)

Summary: It is the inflammation of the fluid-filled sac structure (Bursa) in the area of your shoulder that is underneath the acromion (Subacromial).


2. Supraspinatus tendinopathy

The Supraspinatus is part of a group of shoulder muscles called the rotator cuff.

It has the important role of stabilising and moving the shoulder joint.

As the Supraspinatus tendon is located in the area directly underneath the acromion, it is susceptible to getting compressed.

This can lead issues in the tendon such as:

  • Inflammation (“Rotator cuff Tendinitis”)
  • Degeneration (“Rotator cuff Tendinosis”)
  • Tear (“Rotator cuff tear”)
  • Calcification

What causes Shoulder Impingement?

  • Poor posture (Eg. Rounded shoulders, Thoracic Kyphosis)
  • Repetitive use of shoulder (especially over head)
  • Poor scapulohumeral rhythm
  • Acromial spurs
  • Poor joint centration of the humeral head

Tests for Shoulder Impingement

Note: These tests give a general guide line in diagnosing your shoulder problem.

Many other structures in your shoulder can also make these tests reproduce pain as well.


a) Nature of pain

The area of pain is usually felt deep within the point of the shoulder.

In many cases, pain can also refer down the side of your upper arm. (see above)

Pain is often aggravated in certain positions of shoulder such as over head movements.

b) Painful arc

painful-arc

Instructions:

  • Raise your arm out to the side and over your head.
    • (Also known as Shoulder abduction)

Findings:

  • Unable to lift arm into full range.
  • Pain between 60-120 degrees of abduction.
  • Nil or reduced pain at early (0-60 degrees) and late (120-180 degrees) shoulder abduction.

b) Hawkins Kennedy test

test for shoulder impingement

Instructions:

  • Bring your bent arm to 90 degrees of shoulder flexion in front of you. (see above)
  • Crank your hand down with the help of your other hand. (Shoulder Internal rotation)
    • Do not let your shoulder hitch upwards.

Findings: Reproduction of your shoulder symptoms with the movement.


c) Neer’s test

neer-test

Instructions:

  • Raise your arm a) in front of you and b) to the side with your thumb pointing downwards.

Findings: Reproduction of your shoulder symptoms with the movement.


Shoulder Impingement exercises


Note: These Shoulder Impingement exercises must be comfortable and performed gently. Listen to your body!


Step 1: Stop aLL activities that cause pain

How can you expect your shoulder to get better if you keep exposing it the activities that make it worse?

It may sound really straightforward, but I’ve seen so many people get this first simple step wrong.

… STOP aggravating your pain!

The body can not (…and will not) heal itself if you don’t allow enough time for it to do so.

“… If it hurts, don’t do it!
If feels fine, keep at it!”

Avoid aggravating positions such as over head movements, lifting and sleeping on the painful shoulder!

reaching

Quick tip: When you do use your shoulder, try to keep your elbows as close to the side of your body as possible.


Step 2: Reduce inflammation

If there is excessive inflammation in the area, everything will be painful!

Once the inflammation levels have subsided, we can then start the Shoulder Impingement exercises without aggravating the shoulder again.

a) Anti-inflammatory gel

anti-inflammatory medication for shoulder impingement

Apply the anti-inflammatory gel to the whole shoulder.

Do this 2-3/day.

I prefer products with natural active ingredients like arnica, calendula or hypericum.

b) Non-steroidal anti-inflammatory drugs (NSAIDs)

It is recommended that you take a strong anti-inflammatory medication for at least 7-10 days.

(Please consult your general practitioner before taking any new medication)

c) Ice/Cold therapy

coldpack

Apply an ice pack to your shoulder for at least 10-15 minutes.

Do this 3-5 times per day.

d) Shoulder sling

shoulder-sling

If the pain is severe, you can temporarily immobilize your shoulder for a short period of time.

(… do NOT wear it for longer than 1-2 days!)

e) Try natural products

Taking turmeric and/or fish oil capsules are natural ways to help reduce the inflammation.

Step 3: Reduce pressure on painful structures

a) Shoulder release

This will help decompress the shoulder joint.

  • Place your shoulder muscles into a massage ball onto the floor.
  • Target muscles: Deltoid
  • Continue for 2-3 minutes to cover the entire area.

b) Shoulder traction (with a resistance band)

shoulder traction exercise for shoulder impingement

Instructions:

  • Anchor a strong resistance band underneath your foot.
  • Whilst holding onto the end of the resistance band, start to lean away from the band.
  • Aim to feel a downward pulling sensation in your shoulder.
  • Keep your shoulder as relaxed as possible.
  • Apply more tension to the band if you would like to increase the stretch.
  • Hold for 30 seconds.
  • Repeat 3-5 times.

Note: Do NOT pull into sharp pain. (… especially if you have a tear!)

Step 4: Release tight muscles

The following tight muscles can limit how much you can raise your arm.

Instructions:

  • Place target area on top of a massage ball or a foam roller.
  • Apply an appropriate amount of your body weight on to the ball
  • Continue for 1 minute on each area.
  • Make sure that you cover the whole muscle.
  • (I strongly recommend looking up the exact location of these muscles on Google.)

a) Pec minor

b) Latissimus Dorsi

c) Teres Major

d) Triceps

Step 5: Initial Shoulder Impingement exercises

The goal here is to keep the shoulder as mobile as possible.

Do what you can.
Don’t do more than you can’t…

Overprotecting your shoulder may predispose you developing frozen shoulder. (… and that’s way worse!

a) Pendulum

pendulum

Instructions:

  • Lean over a chair and allow your arm to hang underneath you.
  • Using the momentum of your arm, gently sway your arm side ways/forwards/backwards/circles.
  • Allow the shoulder to move as much as you can without reproducing any pain.
  • Repeat each movement for 10 repetitions each.
  • Alternative:
    • Roll a ball on a table top in a circular motion.
  • Progression: Generate more tension throughout the whole arm as you move the arm.

b) Forward leans

initial shoulder impingement exercises

Instructions:

  • Place your hand on the back of a chair.
  • Lean forward as to bring your arm in an upwards direction.
    • Do this as much as you can without reproducing any pain.
  • Repeat 20 times.
  • Alternative:
    • Roll a ball forwards/backwards on a table top.
    • Roll a ball up/down the wall.

c) Rotations

extrotn-movement

Instructions:

  • Bend your elbows to 90 degrees.
  • Keep your elbows in contact with the side of your body.
  • Proceed to rotated your arm outwards/inwards.
  • Allow the shoulder to move as much as you can without reproducing any pain.
  • Repeat 20 times.
  • Progression: Generate more tension throughout the whole arm as you move the arm.

d) Shoulder flexion with band

Instructions:

  • Lie on your back.
  • Hold a resistance band between your hands.
  • Gently pull the band apart.
  • Keep your elbows bent at 90 degrees.
  • Raise your arms as far as possible without reproducing any pain.
  • Repeat 20 times.

Step 6: Encourage joint centration

If the shoulder bone (… also known as the humeral head) is not centered within the shoulder socket, it can often move into a forwards and upwards direction.

This may increase the chance of impingement in the shoulder.

a) Posterior shoulder release

A tight posterior capsule can push the humeral head forward in the shoulder socket. 

Instructions:

  • Place the back portion of your shoulder on top of a massage ball.
  • Apply an appropriate amount of your body weight into the area.
  • Continue for 1 minute.

b) Posterior shoulder stretch

Instructions:

  • Gently pull your shoulder blades backwards.
  • Without moving your shoulder blades, bring your arm across the body.
  • Pull the arm further with your other hand.
  • Aim to feel a stretch at the back of your shoulder.
  • Hold for 30 seconds.

c) Anti-impingement exercises

Humeral head depression:

You need to get familiar with the sensation of depressing your humeral head in your shoulder socket.

Imagine your shoulder bone is constantly being sucked in a downwards AND inwards direction into the socket whilst you move your arm.

(This may take some time to understand and perform correctly… and that’s fine. Keep at it!)


Extension:

exercise for shoulder impingement

Instructions:

  • Anchor resistance band on top of the door.
  • Face the door.
  • Starting at shoulder height, pull the resistance band down towards your body.
  • Keep constant tension through resistance band throughout movement.
  • Hold for 3-5 seconds.
  • Slowly return the hand back to shoulder height
    • If this hurts, you may want to start at a lower height
  • Repeat 10-30 times. 3 sets.
  • Progression:
    • Start from a higher position.
    • Apply more tension to the band

Adduction:

subacromial bursitis exercises

Instructions

  • Anchor resistance band on top of the door.
  • Stand side on to the door.
    • The affected shoulder should be closer to the door.
  • Starting at shoulder height, pull the resistance band down towards your body.
  • Make sure your palms are facing forward.
  • Keep constant tension through resistance band throughout movement.
  • Hold for 3-5 seconds.
  • Slowly return the hand back to shoulder height
    • If this hurts, you may want to start at a lower height
  • Repeat 10-30 times.
  • Perform 3 sets.
  • Progression:
    • Start from a higher position.
    • Apply more tension to the band

Step 7: Ideal scapula position

By optimizing the scapula position, this will help reduce impingement in the subacromial space.

This is a quick and easy way to reset your shoulders into a more neutral position.

If you ever forget where your shoulder should be, do this:

correct shoulder position

Instructions:

  • Keep your shoulders “long and wide”: Reach and stretch out your hands as far to opposite sides as possible. (see above)
  • RetractionSlightly bring your arms backwards.
    • Make sure you can feel a gentle contraction between your shoulder blades.
    • Do not over squeeze your shoulder blades together!
  • Posterior Tilt: Turn your palms upwards so that your thumbs are angled towards the floor.
    • Imagine the inferior angle (“the pointy part of lower scapula”) is digging into the back of your rib cage.

Take note of your new shoulder position. 

Keep this position and slowly lower your arms down by your side.


Now that you know how your scapula should ideally sit, it is just as important to understand how it should MOVE as you use your arm.

[See video]

Main points:

  • It is VITAL that your scapula moves properly when you lift your arm up. (especially over head)
  • As the arm is raised, the scapula should laterally rotate so that the inferior angle reaches the side of your ribs.
    • This will promote more space in the subacromial space where compression occurs.
  • It can help if you visualize how the scapula should be moving as you use your arm.
  • The scapula should sit flat on the rib cage throughout movement.

This is achieved by learning how to…

Step 8: Activate your Serratus anterior

This muscle is responsible for moving your shoulder blade more effectively as you use your arm.

It is important that you can feel the Serratus Anterior muscle contracting as you perform the following strengthening exercises.

Activating the Serratus anterior:

serratus anterior exercises

Instructions:

  • Assume the wall plank position. (see above)
  • Assume the Ideal scapula position.
    • (See step 6)
  • Activate the Serratus Anterior by pushing your forearms into the wall:
    • Pull your shoulder blades DOWN and AROUND the ribs.
    • Keep your shoulders long/wide.
  • Aim to feel the contraction in the lower and side region of the scapula.
    • (… This is where the Serratus Anterior muscle is!)
  • There should be a balance between the muscles that are pulling backwards and the muscles that are pulling down/around.
  • Hold for 30 seconds.
  • Repeat 5 times.
  • Progression: Whilst maintaining the activation of the Serratus Anterior, slide your forearms up/down the wall.

For more exercises like thisSerratus Anterior strengthening exercises.

Step 9: Strengthening


Maintain the Ideal scapula positioning throughout all of these Shoulder Impingement exercises.

Remember:

  • Tilt the shoulder blades BACKWARDS.
  • Pull your shoulder blades DOWN and AROUND the ribs.
  • Keep your shoulders long/wide.

… This is CRUCIAL!


1. Isometric training

This involves strengthening your shoulder muscles without moving.

This is to make sure that you do not aggravate the symptoms in your shoulder.

You can perform an isometric contraction in ANY shoulder position and in ANY direction.

Example: External rotation (with flexion)

Instructions:

  • Keep your elbows tucked to the side of your body.
  • Gently pull your shoulders back.
  • Hold a resistance band between your hands.
  • Pull the resistance band away from each other.
    • (External rotation)
  • Whilst maintaining the tension on the band, lift your arms up as high as you can with nil pain.
    • (Flexion)
  • Hold this position for 30-45 seconds.
  • Repeat 3 times.

Note: Only push yourself as far as you are comfortable!


2. Dynamic exercises

Progress to these Shoulder Impingement exercises only if you are able to conduct the previous Shoulder Extension, Adduction and Internal rotation exercises easily.

Remember to:

  • Depress the humeral head throughout movement.
  • Maintain the Ideal scapula position.
  • Engage the Serratus Anterior.

a) External rotation

supraspinatus exercises

Instructions:

  • Anchor the resistance band at elbow height.
  • Stand sideways with the affected arm further from the door
  • Pull the band away from your body.
  • Aim to keep your elbow in contact with the side of your body at all times.
    • Think about squeezing a piece of paper between your elbow and the side of your body
  • Repeat 10-30 times
  • Perform 3 sets

b) Internal rotation

ir

Instructions:

  • Anchor the resistance band at elbow height.
  • Stand sideways with the affected arm closer to the door.
  • Pull the band towards your body.
  • Aim to keep your elbow in contact with the side of your body.
    • Think about squeezing a piece of paper between your elbow and the side of your body
  • Repeat 10-30 times
  • Perform 3 sets

c) Flexion

resistance band shoulder impingement exercises

Instructions

  • Stand on the end of a resistance band.
  • Pull the resistance band as high as you can comfortable go without pain.
  • Keep constant tension on the resistance band throughout movement.
  • Hold for 3-5 seconds.
  • Slowly return the hand back to the body.
  • Repeat 10-30 times.
  • Perform 3 sets.

d) Abduction

abduction

Instructions:

  • Stand on the end of a resistance band.
  • Pull the resistance band towards the side as high as you can comfortably go without pain.
  • Keep constant tension on the resistance band throughout movement.
  • Hold for 3-5 seconds at end range.
  • Slowly return the hand back to the body.
  • Repeat 10-30 times.
  • Perform 3 sets.

3. Weight bear exercises

a) Rock back

 

Instructions:

  • Assume the plank position with your knees on the floor.
  • Assume the Ideal Scapula Position.
  • Push your forearms into the floor.
  • Rock your body backwards as far back as possible.
  • Return to starting position.
  • Repeat 30 times.
  • Progression: Increased the amount of weight going through your shoulder by performing the exercise whilst on your hands and feet.

4. Strengthening in functional positions

What exact activity can’t you do because of your painful shoulder?

You need to find an exercise that will mimic the motion of doing this SPECIFIC movement/activity.


For example:

If you have difficulty hanging out your clothes on the clothes line… you can do the following exercise:

meaningful-task

Instructions

  • Stand on the end of a resistance band.
  • Assume the Ideal Scapula Position. (See Step 6)
    • This is to prevent you starting from a slouched shoulder position.
  • Aim to pull the resistance band as high as you can go without causing any pain.
    • (Experiencing a small amount of discomfort is fine!)
  • Keep constant tension on the resistance band throughout movement.
  • Hold for 3-5 seconds.
  • Slowly return the hand back to the body.
  • Repeat 10-30 times.
  • Perform 3 sets.

Step 10: Address Posture

If you have been persistent with these shoulder impingement exercises and are still experiencing symptoms, consider addressing the following postural issues:

a) Rounded shoulders

Having Rounded Shoulders is when the resting shoulder position is in front of the mid line of the torso.

Do you have it?
For more information, check out this blog post:

b) Thoracic Kyphosis

A curved spine will place the shoulders in an ineffective position to function.

Do you have it?
For more information, check out this blog post:

c) Winged Scapula

winged scapula

A Winged Scapula is when the inner border of the shoulder blade protrudes off the rib cage.

The scapula is in a position of anterior tilt and downward rotation which can increase the chance of compression occurring in the subacromial space.

Do you have it?
For more information, check out this blog post:

Common questions:

1. How often should I do Shoulder impingement exercises?

  • Aim for 3/week.
  • Start with 1/week.
  • Monitor and assess how the shoulder responds.
  • Adjust frequency accordingly.

2. How long does it take to recover?

… It really depends!

There are many factors that will influence the time it will take for a full recovery.

Try to focus on consistent improvements.

3. Does the Cortisone injection help?

If you have already been to your doctor, then the chances are that they have already suggested that you get the cortisone injection.

This injection consists of a steroid (cortisone) and an analgesic substance.

The aim of the injection is to:

  • a) Reduce inflammation
  • b) Reduce pain
  • c) Create a “window of opportunity” to progress the exercises.

Sounds great in theory… right?

Yes, it does…

BUT – The problem is that it does absolutely nothing to address the underlying cause of the shoulder impingement.

More often than not – the injection may provide some short term relief, but only to have the pain come back at a later date (… and usually with a vengeance!).

My recommendation:

  • Persist with these shoulder impingement exercises for about 4-6 weeks.
  • If there is absolutely no improvement (… or if it’s getting worse), then it might be the next step to take.
  • It should NEVER be the first thing that you do.

4. Do I need surgery?

My immediate answer: NO.

The reason behind this is that I have a strong belief in healing the body via conservative means.

Please give these exercises a chance before even considering surgery for Shoulder Impingement.

(Keep in mind – not all surgeries are successful!)


What to do next:

1. Any questions?… Leave me a comment down below.

2. Come join me on the Facebook page. Let’s keep in touch!

3. Start doing the Shoulder Impingement exercises!

284 thoughts on “Shoulder Impingement Exercises (UPDATED 2020)”

  1. I was diagnosed with left shoulder impingement about a month ago. Started with shoulder pain and limited rom in January. Avid weight lifter for 30 plus years. No weights since January for upper body. Started pt 3 weeks ago. Making some progress as I notice less pain with the exercises. Most painful to me is trying to put my hair up because it involves keeping my arm up . Anyway, my question is, with this whole virus thing I’ve been walking several miles which seems to aggravate my condition. Should I use a sling when walking and how long does it take to get better. The most aggravating thing for me is sitting at my desk to work. I try to get up every half hour to stretch.

    Reply
    • Hello Carolyn,

      Try to avoid using a sling if possible. (put it into context – I generally only recommend wearing a sling after a shoulder surgery)

      I haven’t assessed you in person so it might be hard to give you specific advice.

      But based on what you have reported:

      – Try to keep your shoulders wide and open as you walk. If you walk with rounded shoulders, esp. if you are swinging the arms whilst walking with a bit of speed, this can flare up some of the tendons involved with shoulder impingement.
      – If your pain gets worse at the desk, make sure your elbows are kept next to the sides of your body. Most people tend to have their elbows flaring outwards for some reason (most likely due to poor work station ergonomics). Also try to keep the shoulders wide and long as well whilst on the computer.
      – Pain with elevation such as when you are doing your hair, try doing it with your elbow pointing directly towards the floor at all times. This should take some pressure of the muscles in the shoulder.

      Hope this helps.

      Mark

  2. Hi Mark,

    I saw your whole shoulder impingement guide and was curious if you could answer some questions.

    I first got rotator cuff tendonitis mid December while sitting in the car and then trying to pull my arm up in a funky way. I then continued to lift and then my left shoulder got tendonitis. I stopped lifting for weeks and I’m still not lifting but then went back to the doctor because the pain never went away and the doctor said I had shoulder impingement of both shoulders.

    I have been doing some external and internal rotation exercises with a band but I’m not seeing any progression. Should I continue but follow your guide instead or what do you recommend I do?

    Reply
    • Hi Christian,

      Internal and external rotation exercise are good to start off with. However – you will need to find the exact position and direction as to which your shoulder is weak in.

      Perhaps you can give the exercises as mentioned on the blog post and see how your shoulder responds from there?

      Mark

  3. Hi Mark
    Thanks for all the information. I started working out in October 2019 and for the past month have been experiencing what I am pretty sure is shoulder impingement. I think it occurred from doing face pulls with too much weight.
    I am sad that I will have to stop working out overhead to improve my condition because I have worked so hard to get to where I am at today.
    Would this have to include bench press?
    Thanks for all your information.
    Cheers

    Reply
  4. Hi Mark,

    Some great info here – thank you

    I’ve been suffering with shoulder pain (which spreads to my rear delts/shoulder blades at night) for around 5 months now, Physio has helped with the mobility element but not the pain – I am leaning towards having a shot in the next month or two, anything else you could recommend (I try and only take anti inflammatories when pain is over 5/10)

    Many Thanks

    Sai

    Reply
    • Hey Sai,

      If you have persisted with physio and exercises for 5 months and the pain is still evident, it might be an option to try the cortisone shot.

      However, more often than not, you might need to find an exercise that specifically targets the structures that are causing you pain. I assume the physio has done this?

      Mark

  5. Hey Mark,

    I felt a pain in my shoulder after swimming once.
    The pain lasted for some time and then I took a long acting corticosteroides shot which relieved the pain but now it hurts again,

    I visited a physician and he asked for x-ray and after doing it and I found out that I have shoulder acromion type II. It hurts with any push exercise and with any rotation of the shoulder and I have been resting for more than month taking anti inflammatory drugs with no improvement, so what do u think I should?

    Thanks in advance.

    Reply
    • Hi Moi,

      I would start the exercises mentioned in the blog post and see how the shoulder responds.

      Generally speaking – injections only give temporary relief.

      Type II Acromion does not necessarily mean it is involved with your shoulder issue.

      Mark

  6. Hey Mark,

    I have been doing physical therapy for about 4 months now, and I still have an issue with the front part of my shoulder whenever I do my exercises. My impingement has almost healed as I am able to move my arms up vertically and horizontally but hurts when my thumbs are pointed down. My therapist still recommends I do my therapy exercises but do you think a steroid cortisone shot would help? Or is continuing my therapy the best thing I can do still?

    Best,
    Nick

    Reply
    • Hey Nick,

      If you have full movement in the shoulder, I don’t think you would need a cortisone injection.

      If you are still having problems with lifting your arm with your thumb pointing downwards (lifting the arm from a shoulder internal rotation position), I feel that you need to focus on strengthening the rotator cuff (most likely supraspinatus and infraspinatus) in a LENGTHENED position.

      The 90/90 arm crank whilst holding a weight is great for this. Only lower as low as you are comfortable with.

      I would also suggest that you ask your therapist to check to make sure you have full glenohumeral joint internal rotation in the 9090 position with hitching.

      Another thing you can check is posterior capsule tightness.

      Mark

  7. Hi Mark,
    I have been playing softball for about 7 years now and recently had to take about 4 months off because of hip surgery. My shoulder has been causing me pain for a couple years, but started hurting more this past summer. ( I am a catcher, but I played 2nd base more that summer). I thought that by taking time off for my hip surgery, it would rest my shoulder, but now that I’ve started throwing again it’s very painful. I haven’t been throwing hard and lifting my arm above my head hurts.
    I am a senior this year and can’t/won’t take more time off because softball is my life. I’ve been doing physical therapy for my hips but can’t afford to do any for my shoulder or to get it looked at in case they insist I can’t play softball. I have been doing the band exercises for the shoulder. The pain is mostly in the center of the shoulder, also somewhat in the back and it feels like it gets stuck when I raise it. If I force it up, it’s very painful. Throwing doesn’t hurt until the arm is up higher. I did use to throw side arm so that might have messed it up some. I do try to stretch them as much as possible.

    Do you think this is shoulder impingement? And should I try to get physical therapy for it? I can’t take any more time off though.

    (Also, I’ve been swimming for 13 years and I do a lot of butterfly)

    Reply
    • Hi Megan,

      Prolonged rest to injuries will generally make them weaker. This is probably why your shoulder started to hurt as soon as you started throwing again.

      It could be impingement. But when you say the pain is in the center of the shoulder, where exactly are you referring to?

      How’s your internal and external rotation movements?

      Mark

  8. Hi Mark and thank you very much for this info. I think it will turn out to be extremely helpful. At the moment my whole shoulder hurts as if it were inflamed (started as mild strained feeling and has deteriorated over several months – no trauma) and then there are movements that I just can’t do because the shoulder just locks and it hurts so much, putting on a coat is the worst or trying to scratch my back! Left arm reaches all the way up to mid shoulder blade, right arm can bare reach behind me and no lifting arm at all! Are there any exercises I could do to slowly regain range of motion and become pain free here? Thank you!

    Reply
    • Hi Gini,

      Sounds like you might be having issues with shoulder internal rotation. (hand behind back, reaching backwards to put on a coat)

      In order to know what exercises to do, You will first need to find out exactly what is limiting this movement. (Eg. Is it tightness? Is it pain? Combination? What’s tight? Whats hurting? When does it hurt)

      Mark

    • Thank you so much for taking the time to reply. It’s def. the pain that limits the movement, no idea where it comes from…. Physiotherapy in Thailand has presented some communication problems and not that great results…

    • Thanks for the reply. Surprisingly the pain begins more on the front side of the shoulder, roughly pec minor region/head of humerus and only when I push it does the posterior capsule region start to hurt and resist movement. Is there anything I can do on my own to alleviate this? Am doing your recommended routine daily (not the advanced exercises) Thank you.

    • Hi Gini,

      There are many muscles at the front of the shoulder.

      The 2 main tendons I am thinking of are:
      1. Subscapularis
      2. Long head biceps.

      (Have a quick google to see if it fits your pain location)

      Mark

  9. Hi Mark
    Great information and explanations. I wonder if you can help me? Three weeks ago I fell two feet onto a concrete floor and landed directly on the point of my shoulder/humeral head. Initially could only passively raise arm above shoulder height but quickly regained power (7 days). It really only hurts at night! (Not sleeping on that side( However it wakes me up. Looking at your tests – I can raise it above my head (mild pain mid range) but can’t even get it to a right angle in front of me! Hand is at least 30 degrees higher than elbow and v painful around the top of my arm in a band. Thumb test very slight pain. Ironically I have no pain playing tennis , mucking out the horses, lifting etc. I hVe had chiropractic treatment which helped considerably as neck and thoracic were locked. And sports massage also helped. Been using laser on it too. Do you think it’s bursitis?

    Reply
    • Hey Fiona,

      Hope you’re okay after falling!

      It is quite possible that you have bursitis.

      (Especially if you don’t really have any issue with playing tennis, mucking on horses, lifting (which I assume you are referring to movements below shoulder height.).

      If this is the case – the inflammation should subside and normal movement should return.

      If you are still having issues in the next couple of weeks, I would feel you may have done something to your tendons/muscles.

      Best of luck!

      Mark

  10. Mark, I am a 67 year old male who has been working out since 15. I have all kinds of grinding noise in my right shoulder. this has not been a problem. Recently, last 4 months, my shoulder would ache after sitting, while working on computer. The ache would go away once I got up and started moving. Recently, I am having numbness down my arm and into the thumb and index finger on right hand. I have gone to physical therapist and was given stretches. There is no weakness in arm and tingling and numbness comes and goes. I can recreate the numbness by holding my arm out and pointing my thumb down, your pendelum exercise also recreates the symptoms. Any idea what this could be and how to resolve. I can live with this just want to keep from getting worse. I can play golf, it does get numb but no pain. Please help. Thanks Jimmy

    Reply
    • Hello Jimmy,

      It sounds like a nerve-related issue.

      Based on the information you have provided, 2 main things that come into mind are:
      – C6 and/or C7 Nerve issue coming from the neck.
      – Radial nerve issue

      C6 and C7 can be checked with an MRI to the neck.

      Radial nerve can be checked with a nerve conduction test.

      If these tests come out clean, it could also be Thoracic Outlet Syndrome (not too common).

      Once you find the cause, then you can start to get specific exercises to treat it.

      Mark

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