Shoulder impingement is extremely common over the age of 40 years. It occurs when the rotator cuff gets impinged in the subacromial space. A rotator cuff is a group of four muscles that surround the shoulder and are responsible for the motion and stabilization of the shoulder joint. Anything that narrows subacromial space will tend to pinch and irritate the cuff. Wear and tear of the rotator cuff tendons with overuse and aging, inflammation of the tendon, and calcium deposits in the tendon all can lead to impingement as the inflamed tendon is often thickened, which increases the chance of it becoming pinched. Repetitive activity at or above the shoulder during work or sports represents the risk factor for shoulder impingement syndrome.

The main symptom of shoulder impingement is pain around the shoulder and often at the outer portion of the upper arm. This pain is usually worse with shoulder motion, especially when reaching overhead or lifting activities.

The goal of shoulder impingement exercises is to gain full mobility in the shoulder joint, strengthen the muscles around the shoulder joint, and to restore the scapulohumeral rhythm that is important for normal functioning of the upper arm.

1. Shoulder blade squeeze– Roll your shoulders back and down. Hold the stretch for 15 seconds and repeat ten times. This exercise helps in activating scapular stabilizers.
2. Pectorals stretch– Stand in a doorway with hands holding onto the door frame just below shoulder height. Gently lean forward and turn the body away from your arm until a stretch is felt in the chest. Hold 15 seconds and repeat ten times.
3. Supraspinatus stretch– Place your hand on the lower back such that the dorsum of the hand touches the lower back. Now, use the other hand to pull the elbow forwards. Hold this stretch for 15 seconds and repeat ten times.
4. Crossbody stretch– Grab the involved arm above your elbow with your opposite hand, and pull it across your body toward your chest until you feel a stretch in your shoulder. Hold this stretch for 10 seconds and repeat ten times.
5. Supraspinatus strengthening -Keeping the elbow straight and thumb pointing up, elevate the arm midway between the front and sideways up to just below the shoulder level. Hold for 10 seconds and gently lower it down. Repeat ten times.
6. External and Internal Rotations of the shoulder with resistance bands-Tie one end of the resistance band to the doorknob and hold the other end in your hand. Keep the arm close to the body and bend 90 degrees at the elbow, bring your hand towards your navel by rotating the shoulder internally and then move your hand outwards by rotating the shoulder externally. Repeat ten times in each direction.
7. Bent over horizontal abduction– Lie on your stomach on the bed with your involved arm hanging over the side. Keep your arm straight and slowly raise it to eye level. Hold for 10 seconds and slowly lower it back to the starting position. Repeat ten times.

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• Neck and Shoulder Conditions