Have your lifts suffered at all from a nagging shoulder pain? If so, then you may have shoulder impingement syndrome. Shoulder impingement syndrome usually occurs when the normal range of motion of the shoulder is compromised in some way. This results in pain when you lift the shoulder overhead. Although shoulder impingement can be a colossal pain in the butt for overhead athletes (weightlifting, gymnastics, swimming, etc.), it does not have to ruin your training. In this post we are going to explain what shoulder impingement syndrome is and how to help treat it.
A Brief Overview Of Shoulder Anatomy
The shoulder is one of the most vulnerable joints in the human body. Unlike simple joints, which are secure, but limited. The shoulder joint is unlimited and virtually insecure. The shoulder joint is called a ball and socket joint. If you look at the shoulder from the front with no muscles and tendons present, you will notice that it is not directly connected to the ribcage by anything. The only things connecting the shoulder to the body are tendons, ligaments and muscles.
All of the muscles that surround the shoulder contribute in some way to the stability of the shoulder. There is one group of muscles that specifically is designed to stabilize the humeral head in the socket. These are called the rotator cuff muscles. If these muscles are not developed properly, then the shoulder may become unstable. Additionally, if the big muscles that are around the shoulder become unbalanced, then they can “pull” the shoulder either too far forward or backward.
What Is Shoulder Impingement Syndrome?
When the shoulder becomes unstable either through a weak rotator cuff and or imbalanced muscles, you can get shoulder impingement syndrome. With an unstable shoulder, performing overhead motions, such as pressing or pull-ups, can lift the humeral head out of the socket and “pinch” one of the rotator cuff tendons.
The pinched muscle then becomes inflamed and swollen. Once the injury happens, lifting the arm overhead can cause pain. The muscle tendon that gets pinched is typically the supraspinatus muscle. It runs just on top of the humeral head in a very tight and narrow space. Once it gets pinched, the space gets even smaller from the swelling.
For most lifters this is a vicious cycle. The tendon needs time for the swelling to go down, but at the same time the individual with the shoulder impingement needs to use their arm for everyday tasks. One small bump or hit of the tendon again can set the whole injury back into motion and further delay recovery.
Since you will try to avoid certain motions, the body will try to compensate. A kyphotic thoracic posture and anterior humeral glide are usually the result. This is often the bodies protective mechanism for shoulder injuries.
This is far worse than the actual impingement because the body now starts to develop faulty upper body motions that will take lots of time to correct.
How To Eliminate Shoulder Impingement Syndrome
*Disclaimer* Before we continue, I just want to clarify that I am not a doctor or medical professional of any kind. This article is not intended to treat, diagnose or cure any illness or disorder. This article is for entertainment purposes only. Always seek the advise of a medical professional anytime you feel you need a diagnosis. Never self-diagnose!
Eliminating shoulder impingement syndrome is actually much more simple than most people think. First and most importantly, you need to REST!
The problem with most lifters is that the pain from the impingement quickly starts to subside in a few days. Most lifters then assume that all is well and they can resume kicking ass. This is not the case.
Although the pain may be gone, the injury may still be there and the faulty motor patterns that got you into this mess in the first place are definitely still there. The injury will just come right back if you continue to keep doing what you were already doing.
Think about it, if your biomechanics were perfect from the start, then you probably wouldn’t have gotten injured in the first place. With that said, if you have a shoulder impingement, then there is definitely a movement issue that needs to be addressed.
After you have given a descent amount of rest to your shoulder, the time arrives to start moving your shoulder.
Mobilization is the first type of work that should be done to your shoulder. After an injury, the tissues surrounding the injured area become very stiff. This is done as a protective mechanism by the body to try to immobilize the damaged area.
Unfortunately, this stiffness paves the way for poor movement patterns during future training sessions. To avoid this, the lifter must stretch out all of the soft tissues surrounding the affected area.
This is especially true for muscles in the neck. In particular, the upper trapezius and the levator scapulae. These muscles are primarily responsible for scapulae elevation. If these muscles become tight from an injury, then they will pull on the shoulder blades and destabilize the shoulder. Thus leading to a re-injury, or even a winged scapulae. HERE is an excellent corrective exercise video for stretching both muscles.
As those two muscles are getting too tight another muscle group is becoming too weak, the serratus anterior. The serratus muscle is responsible for scapulae protraction and stabilization. If this muscle becomes weak, then the pull of the traps and levator scapulae wing the scapulae off its normal trajectory and de-stabilize the shoulder.
Dr. Evan Osar, author of Corrective Exercise Solutions to Common Shoulder and Hip Dysfunction, has an excellent video explaining proper serratus motor control and activation.
Once you have spent some time with the mobilization drills explained in the previous section, you are all good to go back to your regular strength training regimen. Wait! There’s a catch. You still have to keep doing the mobility drills.
Most people after an rehab work and/or mobility work just go right back into their old program without a second thought and guess what happens, they get injured again.
So here’s the deal:
- Perform mobility drills 1-2 days a week
- Re-evaluate you training program to make sure no imbalances will be made
Are you doing too much pressing and to little pulling? Are you obsessed with your bench press and neglecting your pull-ups? Are you training your abs, but really training your hip flexors?
These are all questions you need to address. Too many lifter are focusing too much attention on the amount of weight they lift rather than the quality of the lift itself. The quality is going to keep you lifting and getting results well beyond your 20’s.
Julien Pineau of StrongFit, describes, in an excellent interview, some basic info on determining imbalances and weaknesses in your lifts. Eliminate your imbalances and you eliminate your chances for injury.
Shoulder impingement syndrome videos and blog posts are all over the internet. I know because I have had shoulder impingement multiple times. No matter how many videos or posts I have read, I never got better. I wish I could tell you that there is some magic exercise to fix shoulder impingement, but there isn’t. It takes time, effort and patience. The same things required to lift big weights. Some times an injury is a good thing though because it forces you to reassess yourself and find ways to continually improve yourself. This is how progress is made.