The shoulder is one of the most common areas of chronic upper body pain, particularly among an exercising population. A low-grade shoulder ache can progress quickly to more severe pain if not treated properly. However, an understanding of the basic mechanism of chronic shoulder pain, as well as simple treatment options, can stop shoulder pain dead in its tracks and get you back to exercising quickly.
What Is Shoulder Impingement Syndrome?
First off, let’s define what we’re talking about here. When I’m referring to shoulder pain, I’m talking about discomfort in and around the shoulder joint itself. Since the shoulder joint is so complex (with several muscles, tendons, and ligaments running through the joint), it is often difficult to diagnose injury to a specific structure, either on manual examination or MRI. As a result, a simple “catchall” diagnosis used in the medical and rehabilitation communities is shoulder impingement syndrome (SIS).
The name describes the problem well. Soft tissue in the shoulder (often a rotator cuff tendon, or the small fluid-filled cushion called a bursa) gets pinched in the narrow space it has to slide through as your arm moves. Less room means more friction, and more friction means irritation.
Symptoms: What Shoulder Impingement Feels Like
The hallmark symptom of SIS is pain when raising the arm in front or out to the side of the body, with increasing levels of pain occurring as you reach shoulder height. The pain is generally a result of damage to soft tissue, such as tendons or muscles. This damage results in swelling of the injured soft tissue. As this swelling increases, it begins to reduce the space within which other soft tissue can move, which can then result in further damage and greater inflammation. Sounds like a vicious cycle, right? Well, it’s not good, but fortunately there are some simple treatment options.
A quick self-test: raise your arm slowly out in front of you, then out to the side. Pain that builds as you approach shoulder height, then eases past it, is the classic impingement pattern. It’s not a diagnosis, but it’s a strong hint you’re in SIS territory.
Before I get into those treatments, however, I want to caution everyone reading right now that even if you think you don’t have to worry about SIS or other shoulder pain, you should reconsider. One of the biggest predispositions is our poor seated posture.
Are You At Risk?
Think about the position you’re sitting in reading this article right now — leaning into the computer screen, shoulders rounded forward, upper back rounded, head protruding forward and looking down. This is the posture we have during most of our day. When you consider the fact that body tissues are viscoelastic (which is a fancy way of saying they get “stuck” in the position they’re in most of the time), our posture predisposes all of us to SIS on some level. This seated posture results in tightened chest and shoulder muscles, while at the same time weakening upper back muscles. The end result from a postural perspective is some variation of the Hunchback of Notre Dame. Well, maybe I’m being a little dramatic, but the fact still remains that our posture predisposes even the most fit exercisers to SIS, as that rounding forward of the shoulders puts the soft tissue in the perfect position to be injured when we exercise (or even do the activities of daily life).
If that description felt familiar, the fix is very trainable. We wrote a full guide to rebuilding the muscles that hold you upright: 5 Best Strength Training Exercises to Improve Posture. It pairs well with everything below.
So, what’s the fix, you might ask? Well, it depends on your level of pain, and the amount of time that has passed since your symptoms presented themselves.
Treatment: The Two Phases
With that established, there are two phases to injury treatment. The first phase is the acute/symptom management phase, and the second is the long-term treatment phase.
Your Recovery Roadmap
Select each phase to see what it involves.
Ice the shoulder 2–4 times per day for about 20 minutes (especially post-exercise). Use NSAIDs as directed and tolerated. Avoid movements that push pain above a 6 out of 10, but keep the joint moving with light, comfortable work to drive blood flow to the healing tissue.
Strengthen the muscles around the shoulder blades and upper back, stretch the tight chest and shoulder muscles, retrain your daily posture, and clean up your exercise technique so the joint stops getting pinched in the first place.
In the acute/symptom management phase, you are trying to decrease pain and inflammation. To do so, you should ice the injured shoulder 2–4 times per day for about 20 minutes each time (particularly post-exercise), and use NSAIDs (like Motrin or Aleve), as directed and tolerated. In this acute phase, you should avoid movements that elicit pain, but not necessarily all movements. Movements (ranges-of-motions or loads) that result in a pain level of greater than six on a pain scale of ten should be avoided, as they will result in greater damage. But, movements that cause some discomfort (but not pain) can be performed. In fact, doing so may be a good idea, as these movements can bring blood flow to the injured area and promote healing.
Rotator cuff exercises (raising the arms with low or no weight to mid-chest level), or even low load upper body pulling exercise (curls and rows) can be a great way to drive blood flow to damaged tissue to speed up regeneration and remodeling. However, overhead motions and movements with the elbows raised up to shoulder level (like while bench pressing or doing pushups) should generally be avoided, as these can result in pain and further damage to the joint. Also, please keep in mind that even if your shoulder is injured, you can still perform lower body exercise and improve other aspects of fitness, so don’t think all is lost!
As for long-term treatment, this has to do with getting to the underlying cause. As I mentioned earlier, SIS is really posture-related for a lot of people, but there is a technical component with respect to exercise that can be addressed as well.
The Best Shoulder Impingement Exercises
The best shoulder impingement exercises strengthen the muscles around the shoulder blades and upper back while stretching the tight chest muscles that pull you into a rounded position. You don’t need a gym or special machines for this. You need a resistance band, a doorway, and a few minutes a day.
For the posture component, aggressive strengthening for the musculature around the shoulder blades and back is necessary. Rowing motions performed with bands or resistance tubing will usually do the trick. Going hand-in-hand with the strengthening component is increasing flexibility to the musculature of the chest and shoulder. Gentle chest stretching daily can help loosen up those tight chest muscles, and aid in the development of upper back strength.
For a simple daily routine to combat poor posture, do 4 sets of 20 reps of rows with resistance tubing, combined with 4 sets of a doorway chest stretch. Doing this daily will help to address some of the underlying muscle imbalances that caused the injury in the first place.
If you want to add one more tool, band internal and external rotations are a physical therapy staple for the rotator cuff, and both Harvard Health and the Hospital for Special Surgery feature them in their impingement programs. Keep the elbow tucked at your side, rotate the forearm out and back in against light band tension, and stop well short of pain.
How Long Does Shoulder Impingement Last?
For most people with the low-grade, chronic kind of shoulder pain we’re talking about here, it does go away with consistent work. Harvard Health estimates that with posture correction and a routine like the one above, you should start to feel improvement in two to six weeks, with more complete resolution around 12 weeks. If your pain isn’t improving on that kind of timeline, or it’s getting worse, stop guessing and get evaluated by a physician or physical therapist.
Exercises to Avoid with Shoulder Impingement
While the shoulder is irritated, a few movements reliably make things worse. The pattern to remember: anything that raises the elbows to shoulder height or takes the arms overhead squeezes the exact space that’s already inflamed.
Skip for Now
Overhead presses and overhead reaching under load. Bench presses and pushups with the elbows flared out to shoulder level. Any range of motion or load that pushes pain above a 6 out of 10.
Do Instead
Pressing with the elbows tucked to roughly 45–60 degrees from your sides. Rows, curls, and rotator cuff work at light loads. And all the lower body training you want.
From an exercise standpoint, try to be very aware of posture. Keeping your chest and head up, shoulder blades pulled together, and abdomen tight – while you’re exercising – puts your body in the least likely position to be injured. While in the early stages of recovery, be cautious of overhead motions as well as any upper body pressing that has your elbows rotated up to shoulder level. Instead, keep your elbows at approximately 45–60 degree angles with your sides — this keeps the shoulder joint in a much better position for soft tissue to move around freely.
These limits are temporary. As the pain settles and your upper back gets stronger, overhead pressing and full-range work come back into your program. The elbow position habit, though, is worth keeping for life.
Fixing Your Posture for Good
Also, keep in mind that it’s just not enough to strengthen and loosen muscles; your posture needs to improve (since that’s likely what caused the problem in the first place). Try sitting up straight (keeping your shoulders directly above your hips), with your shoulders and head back. Doing so will help enhance the effect of the postural strengthening and stretching you’re doing.
Good posture also takes more muscle than most people expect. In our guide to the 5 best strength training exercises to improve posture, we count upwards of 30 muscles involved in holding you upright, which is why no single stretch was ever going to fix the problem. That guide walks through five exercises: squats, planks, side planks, shoulder blade squeezes, and supermans. Two of them deserve a special mention here, because they attack the exact weaknesses behind most shoulder impingement.
Shoulder Blade Squeezes
Strong muscles that pull the shoulder blades back and down are critical to good posture, and they’re the same muscles that keep your shoulder joint out of the impingement position. Squeeze your shoulder blades back and down, hold briefly, and repeat for sets of 10. You can do these anywhere, in any position, with zero equipment.
Supermans
Lying face down and lifting your arms and legs off the floor activates nearly every extensor muscle on the backside of your body. Those are precisely the muscles that a day of sitting weakens, so a few sets of supermans each week directly counters the hunched-forward pattern that set your shoulder up for trouble.
The Bottom Line
So, now you know about shoulder impingement syndrome, its causes, treatments, and that we’re all really predisposed to it. Armed with this knowledge, hopefully you’ll be able to exercise injury-free for a long time to come. Use the quick check below to see whether your current habits are helping your shoulder heal or holding it back.
Are You Treating Your Shoulder Right?
Check each statement that’s true for you right now.
You’re managing symptoms and attacking the cause at the same time, which is exactly the formula. Stay consistent with the daily routine, and reintroduce overhead work gradually as the pain fades.
Look at the boxes you left unchecked. The daily rows and chest stretch are the highest-value habit on the list, and the pain-scale rule is what keeps you from restarting the vicious cycle.
If most of these are unchecked, your shoulder is probably managing you instead of the other way around. Start with two habits today: the daily band rows with a doorway chest stretch, and the 6-out-of-10 pain rule. A coach can help you build the rest into your program.
Build Strength Without the Shoulder Pain
An AFS exercise physiologist can adapt your program around an irritated shoulder, so you keep making progress everywhere else while it heals.
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Sources
- Harvard Health Publishing. How to treat shoulder impingement. Harvard Medical School, February 2026.
- Hershfield N. Exercises for Shoulder Impingement, from a PT. Hospital for Special Surgery Health Library, 2023.