Exercises for impingement of shoulder tendonitis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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Shoulder impingement refers to a problem where the rotator cuff tendon group of the shoulder gets pinched between the upper arm bone (humerus) and the edge of the shoulder blade (acromion).

Improving shoulder movement can help control soreness in the shoulder. Impingement leads to restricted range of motion. The aim of exercise therapy is to improve movement in the shoulder through joint mobilization, manual stretching, and other exercises. Active movement and stretching also helps restore movement and begins the healing of damaged tendons.

Careful stretching is important during the healing process. Stretching lengthens the tendons easing soreness and helping the shoulder return to normal health.

As healing continues different types of exercises are used.

Isometrics are exercises where the muscles are tightened but no movement occurs. These types of exercises maintain tone without stressing soft tissue.

Progressive resistive exercises (PREs) are used in rehabilitation. Some of these choices include pulley systems, free weights, rubber tubing, manual resistance, and computerized exercise devices. PREs apply graded resistance to help muscles gain endurance and strength. These exercises typically start with lighter weights with lots of repetitions, and as endurance increases, more weight is gradually used with fewer repetitions.

Specific rehabilitation exercises. Do not do these without checking with your physician or therapist first.

Overhead Stretch
Stand with your arms at your sides. Lift one arm straight up and over your head. Grab the elbow with your other arm, bend the straightened arm and exert gentle pressure to stretch the arm as far as you can.

Cross-body Reach
Stand and lift one arm straight out in front. Keeping the arm at that height, bring it to the front and across your body. As it passes the front of your body, grab the elbow with your other arm and exert gentle pressure to stretch the shoulder.

Towel Stretch
Drape a towel over the opposite shoulder, and grab it with your hand behind your back. Gently pull the towel upward with your other hand. You should feel the stretch in your shoulder and upper arm.

Stand with hands at sides with no weight in either hand. Raise shoulders to the ears and hold for five seconds. Relax for five seconds. Perform this sequence 10 times, 3 times daily. As pain subsides, hold light weight dumbbells of equal weight in each hand while performing this exercise. Gradually add weight.

Bicep Curls
Stand with arms at sides while grasping 2- to 3-pound weights in each hand, held palm forward. Flex the arms at the elbow to approximately 100 degrees, or to the point of pain. Hold this position for 5 to 10 seconds. Return to the start position. Rest for 5 seconds. Repeat this exercise 10 times. You can increase the weight as pain lessens and strength improves.

Triceps Curls
Stand with arms overhead while grasping 1-2 pound weights. While keeping the upper part of the arms next to the ear, bend the elbows so that the dumbbells are lowered behind the head. The point of the elbows should be pointing towards the ceiling. Hold this position for five seconds. Return to the starting position and relax for five seconds. Perform this sequence 10 times, 3 times daily. As pain lessens, add a bit more weight.

Stand with one foot in front of the other. Reach back with both arms and slowly swing them forward, then swing them backward. Do not force it. This should be a pleasant swinging motion. Repeat this sequence 10 times, at least 3 times daily.

Pot Stirrers
Bend forward at the waist and rest the hand of the unaffected arm on the knee. Let the affected arm dangle and let it swing clockwise for 20 reps and then counterclockwise for the same number. Repeat this sequence at least 3 times daily.

Shoulder Rotation
Stand in a doorway with affected side arm bent at the elbow and the palm of the hand against the door frame. Turn the body away from the injured side until a gentle stretching is experienced in the injured shoulder. Hold this position for 10 seconds. Return to the starting position. Relax for 10 seconds. Repeat this sequence 10 times at least 3 times a day.

Shoulder Flexion
Stand next to a wall. With the palm of the injured side arm turned towards you, slowly slide the forearm and then the upper arm up the wall by moving closer to the wall. Slide the arm upward to the point of initial pain. Hold this position for 10 seconds. Return to the initial position and relax for 10 seconds. Do ten reps, at least 3 times daily.

Chicken Wing
Bend the elbow of the affected arm and place it behind you. Grab the wrist with your good hand and gently pull. Hold for 5 seconds. Do 10 reps at least 3 times daily.

For more information on tendonitis, visit our sister site:

Tendonitis and PRP

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