Shoulder impingement (also now commonly called rotator cuff tendinopathy) is an injury we see frequently at Onward because of our highly active patient population. With highly active populations such as CrossFitters and weightlifters there are a few key areas to address if we want to rapidly improve shoulder impingement pain.
Step One: Improve Rotator Cuff Strength
Most people have worked on strengthening the rotator cuff…but quite frequently poorly. Why do we say that?
Improving rotator cuff strength is a must for those experiencing shoulder impingement pain. However, we often see exercises given to patients that are not challenging enough to actually get stronger muscles. We take squats, bicep curls, and bench press close to failure, but don’t treat the rotator cuff with the same intensity. The next misstep is they are not taking you to the positions that you are having difficulty with.
For example, if you have only have pain at the top part of performing an overhead press, then working on banded rotator cuff strength movements with your arm down by your side is not going to get the job done. We’ve got to challenge strength through the full range of motion of the shoulder.
An example exercise for this goal would be a banded foam roll up the wall. This movement works on shoulder mobility overhead while also really challenging the rotator cuff.
Step Two: Increase Shoulder Mobility
We first must do a detailed breakdown of the mobility demands that your activity requires and then assess where your current mobility is. We don’t guess where your mobility limitations are. A full assessment is always done to determine if there is more joint or muscular restricting mobility.
One example of this would be an athlete getting pain during the arch position of their kipping pull-up. If their lat mobility is limited, they will have a difficult time achieving proper open shoulder positioning for the arch during a kipping motion. If we find that to be the case, an exercise we love is a lat contract/relax like in this example.
Step Three: Increase Upper Back Mobility
Alongside step two, we move to assessing thoracic spine mobility. Many people can develop upper back stiffness from many hours of sitting at work. When the upper back is stiff, it places increased demands on the shoulder joint going overhead . After assessing thoracic mobility we can begin addressing limitations with exercises like this foam roller variation.
Step Four: Analyze Your Programming
The last step after working through the above is to look into your recent programming. When injuries occur, we will often find recent examples of over programming certain movements that led to an athlete developing shoulder impingement symptoms. By altering training for a period of time, we can then begin rebuilding your shoulder back up. Ultimately, we’ll build resilient shoulders to decrease the chances of dealing with this injury again.
If you are tired of dealing with shoulder impingement pain keeping you from the activities you love doing, we’d love to help you out. Schedule an appointment!