T Nation

Slight Shoulder Impingement


#1

Whats are the best exercises to strengthen the rotator cuff with a slight impingement. I can more or less only feel discomfort when moving around the arm when cold and only then it's very minor, the pain/pinching is felt when arm is say 80 degrees or higher, more so if the elbows are in line with the body. I have been doing basic 1 arm on knee external rotations (these twinge a little on the first couple of reps) and kneeling rotations arm flat against side rotating outwards with a cable (these don't seem to cause any twinges but it may just be because I am warmed up). I've lowered pressing volume to about 1/3 of my back work and have eliminated vertical pulling movements for now (I get minimal if any discomfort pressing in this manner).

Are the 1 arm dumbell external rotations contraindicated if I am getting a slight twinge in the shoulder doing them? Would anyone know a decent exercise progression to treat impingement syndrome? As I said it's fairly minor, I have no loss of strength and full ROM (with slight pain) but I dont' want it to get worse.


#2

You should purchase "The seven minute rotator cuff solution" a good book, only about $15 and in an easy to read manner, reviews shoulder anatomy, goes through exercises that are most likely to cause impingement, and how to rehab injuries. Also, demonstates exercises. Pick it up.

Also, until you find out the cause, I would stay away from behind the neck presses, any benching lowering the bar high on the collarbone, and upright rows. While doing side lateral raises keep your palm level with the floor (don't raise your palm with the pinky side higher than the thumb). These exercises have the highest likelihood of causing impingements, although some people will have no problem at all with them. Other people have an acromion process that makes impingement more likely to occur.

Good luck.


#3

Oh, ice your shoulder after your workouts. Although it may be difficult to reach the deep areas of your shoulder, it may offer some decrease in the swelling of the bursa sacs that become inflammed from the inpingement.


#4

Incase you didn't know, stretching the HELL out of your pecs and lats will help the problem very quickly.

Some good stretches are using a doorframe for your pecs and holding onto a pillar at about waist height and bending back for your lats.

Static stretching will probably be best. Try 3 sets of 30 seconds after your workout (increased blood flow will help heal scar tissue) and before you go to bed (when your CNS isn't so fired up).

Good luck!


#5

I have no idea of your lifting history. However, I'll give you the same advice I give everyone who has that same problem.

  1. Stop all barbell bench pressing

  2. Use the "Shoulder Horn."

  3. Ice when inflamed.


#6

is it a good idea to do shoulder horn, eg arm perpendicular to body external rotations with a active impingement tho, should I continue with this exercise despite the occasional twinge, sometimes I feel the twinge deeper into my chest area but I think is refered.


#7

atm I am stretching pecs and lats 2 x 20 seconds after every workout and a few other times per week, and I ice the sore shoulder 10min or so using frozen cups of ice afterworkouts and whenever else I get a chance. It's definately not getting worse but it's hard to tell if it's got any better, just want to know if I am retarding my recovery when doing exercises like external rotations that cause the occasional twinge?


#8

Even if its not inflammed, I still ice my shoulder just because there is probably damage so minute, that I can't feel it, yet ice will help. Also, I agree with stopping the barbell bench pressing. Good words of wisdom :slightly_smiling: