A rotator cuff impingement or shoulder impingement is generally caused by excessive overuse of the shoulder joint and its surrounding tissues - an issue frequently seen in athletes or regular gym goers.
Like many other physiological injuries, the use of certain stretches and exercises can aid in managing the symptoms of this condition, with said exercises even speeding up recovery in certain cases.
The most effective exercises for rotator cuff impingement are those that directly involve internal and external shoulder rotation in an isolated manner.
Furthermore, stretches that target the shoulder may be used so as to retain full mobility of the joint, as well as to improve venous flow to the area for the purposes of recovery.
Shoulder or rotator cuff impingement is a condition wherein the connective tissues of the shoulder rub against bones or other tissue so as to result in damage and catching when repetitive motions are performed.
It is referred to as a rotator cuff impingement because the tendons of the rotator cuff structure are affected to the greatest degree, especially during overhead rotation of the arm.
Cases of rotator cuff impingement can vary in terms of severity and symptoms, with some individuals having a rather minor impingement but experiencing severe pain while others may be in need of corrective surgery yet also experience no pain whatsoever.
Apart from other factors like seeking the advice of physicians and using over-the-counter anti-inflammatory drugs, performing exercises to reinforce and stretch the rotator cuff is one of the best ways to help alleviate symptoms.
Even a light amount of resistance induced by rehabilitative exercise can result in improved tissue density and cohesion, resulting in stronger and healthier shoulders over time.
If carried beyond the point of rehabilitation and into physical training, this particular benefit can even result in a reduced risk of injury in the future - so long as the exerciser is careful not to overdo it, as doing so can result in detrimental effects rather than rehabilitative ones.
Injuries of connective and muscular tissue can result in reduced mobility within a joint’s range of motion.
In the shoulder joint, this can appear as the patient only being capable of moving their arm to a certain degree, with further movement in such a direction either resulting in pain or requiring great strain to achieve.
This is most often rehabilitated through dynamic stretches and reinforcement of the tissues therein, with rehabilitative exercise being particularly appropriate in this case.
Proper exercise and stretching of soft tissues can result in an increase in blood flow to the area being stimulated, causing greater nutrient deposition and allowing greater filtration of cellular waste from the general area.
Furthermore, exercise is known to raise the blood pressure and heart rate of an individual, further compounding this factor and aiding in general systemic function.
Rotator cuff impingement can present as several symptoms due to the irritation and damage occurring at a histological level, with pain along the top of the shoulder being the most common.
Other symptoms associated with the possibility of shoulder impingement are weakness of the connected arm, limited overhead extension mobility of the arm (that does not present as stiffness) as well as a clicking or snapping feeling encountered during shoulder rotation.
Proper stretching and exercise of the affected shoulder can help alleviate these symptoms, especially when combined with other medical procedures advised by a physician.
The anterior deltoid stretch is meant to lengthen the tissues at the front of the shoulder, with a particular focus on the front-facing head of the deltoid muscle group.
Individuals with particularly poor overhead mobility may have trouble performing this stretch, as it involves gripping an object tall enough to step beneath while maintaining isometric deltoid muscle contraction.
As such, if you experience any sort of pain while performing this stretch, it is best to avoid it entirely.
Raising the affected arm overhead and grasping a stationary object (such as a doorframe or pull up bar), the exerciser will slowly shift forward while maintaining their grip upon said stationary object.
This should result in the shoulder being stretched from the front, with a concurrent stretching of the pectoral muscles on the same side.
It is best to perform this stretch with the elbow bent somewhat, as fully extending the elbow can place strain on the joint if the torso is shifted too far forward.
The elbow back stretch or posterior shoulder stretch is a simple static stretch that primarily targets the posterior head of the deltoid muscles, though the connective tissues of the rotator cuff are also affected to some small degree as well.
Drawing one arm across the chest with the elbow fully extended, the exerciser will pull their other arm inwards as it bends over the front of this opposite extended arm.
If performed correctly, the exerciser should feel a stretching sensation along the back of their shoulder and trapezius muscle.
As a static stretch, the exerciser should simply hold this position until a sufficient length of time has passed before ending the repetition.
Internal rotation of the shoulder refers to moving the arm inwards (towards the midline of the torso) as the elbow is bent - a primary function of the rotator cuff and one of the main physiological functions that is impacted when an impingement becomes severe enough.
In turn, exercising this particular biomechanic with additional resistance is simply the act of performing the motion with the use of a dumbbell or similar weighted object.
For the greatest isolation of the shoulder girdle, internal rotation exercises may be performed in a lying position, although it is usually performed standing as well.
To perform the exercise, the exerciser should select a very light amount of weight gripped in the hand of the injured side.
Then, bending the elbow so as to point the fist sideways, the exerciser will draw the forearm inwards towards their stomach until their maximum shoulder range of motion has been reached.
Once this is completed, the exerciser can simply reverse the rotation back to the starting position and continue the set as needed.
Note that using an excessive amount of weight during this exercise can actually worsen your impingement, and it is best to first seek out the advice of a medical professional prior to attempting any sort of weighted exercise while suffering from such a condition.
Just like weighted internal rotation exercises, external shoulder rotation with additional resistance is an excellent method of rehabilitating a rotator cuff impingement when performed in the correct manner.
As internal rotation is known to be an adduction of the arm towards the midline of the torso, it is no stretch to imagine that external rotation is abduction of the arm away from the body itself, stretching the arm towards the side instead.
Exercising this biomechanic simply requires a dumbbell or similar weighted object to perform, and can be done while either in a lying or standing position.
Gripping a dumbbell or similar weighted object in the hand of the affected side, the exerciser will bend their elbow so as to face the hand away from the body.
Then, to begin the repetition, the exerciser will rotate their shoulder so as to move the hand further outwards, stopping once the maximum range of motion of the shoulder has been achieved.
Returning to the starting position indicates that the repetition has been completed.
Just as excessive weight can worsen the symptoms of a shoulder impingement during internal rotation exercises, so too can this occur during external rotation exercises. Prior to attempting any sort of rehabilitative actions with resistance equipment, it is best to consult a physician so as to avoid any worsening of your condition.
As a final note, we would like to remind exercisers that an impingement of the shoulder is a clinical condition, and that the safest way to go about remedying the situation is to seek out the advice of a medical professional.
While stretches and exercises are indeed a significant part of recovering from physiological injuries and conditions such as a shoulder impingement, performing these methods improperly can worsen the condition or otherwise impede recovery.
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2. Clausen MB, Bandholm T, Rathleff MS, Christensen KB, Zebis MK, Graven-Nielsen T, Hölmich P, Thorborg K. The Strengthening Exercises in Shoulder Impingement trial (The SExSI-trial) investigating the effectiveness of a simple add-on shoulder strengthening exercise programme in patients with long-lasting subacromial impingement syndrome: Study protocol for a pragmatic, assessor blinded, parallel-group, randomised, controlled trial. Trials. 2018 Mar 2;19(1):154. doi: 10.1186/s13063-018-2509-7. PMID: 29499710; PMCID: PMC5833202.