What Is Shoulder Impingement?
The shoulder is one of the body’s most mobile joints. It allows us to reach, lift, rotate, push and pull in many directions.
The rotator cuff is a group of four muscles and their tendons that help stabilise the shoulder and control its movement:
– Supraspinatus helps lift the arm away from the body.
– Infraspinatus helps rotate the arm outwards.
– Teres minor also supports outward rotation and shoulder stability.
– Subscapularis helps rotate the arm inwards.
“Shoulder impingement” has traditionally been used to describe irritation around the rotator cuff and the space beneath the acromion—the bony projection at the top of the shoulder.
Our understanding of shoulder pain has since developed. Pain isn’t always caused by a tendon being physically trapped or pinched. Clinicians may now use the term **rotator cuff-related shoulder pain**, which recognises that tendon sensitivity, changes in activity, muscle function and other factors can all play a part.
What might it feel like?
People with rotator cuff-related shoulder pain may notice:
– Pain at the front, top or outside of the shoulder.
– Discomfort when lifting the arm to the side or overhead.
– Pain when reaching behind the back, such as fastening a bra or putting on a coat.
– Difficulty reaching into cupboards or lifting objects.
– Pain when lying on the affected shoulder.
– Weakness or discomfort when carrying shopping bags.
– A painful arc when raising the arm—often somewhere between 60 and 120 degrees.
– Discomfort during planks, press-ups or weight-bearing Pilates exercises.
Symptoms can vary widely. Some people experience mild discomfort, while others find everyday movements challenging.
Why does it happen?
There’s rarely one single cause. Symptoms may develop when the shoulder is asked to do more than it is currently prepared for, or when several contributing factors come together.
A sudden increase in activity
Adding heavier weights, doing more overhead exercises or making a big change to training volume can place extra demands on the shoulder before it has had time to adapt.
Repetitive movements
Repeated reaching, lifting, throwing or overhead work may contribute to symptoms, particularly if the shoulder isn’t accustomed to that level of activity.
Rotator cuff strength and endurance
The rotator cuff helps control the shoulder during everyday tasks and exercise. Building strength and endurance can support the shoulder’s ability to manage these demands.
Changes in tendon capacity
Tendons can change as we age. These changes don’t automatically mean there’s pain or injury, but they may influence how the tendon responds to changes in activity or load.
Upper-back mobility
Movement through the upper back can influence how comfortably someone lifts their arm overhead. Limited mobility may be one factor to consider.
Previous injury or reduced activity
A past shoulder injury, a period of inactivity or immobilisation may affect strength, confidence and tolerance for movement.
Hormonal and age-related changes
Midlife hormonal changes may influence musculoskeletal symptoms and tendon health. However, shoulder pain should not automatically be attributed to menopause.
Poor posture alone does not explain shoulder pain, and there’s no single “perfect” shoulder position that guarantees pain prevention.
How can Fitness Pilates help?
The aim is to keep clients moving, support their confidence and gradually build strength—without repeatedly aggravating their symptoms.
In Fitness Pilates, this can mean choosing controlled movements, a comfortable range of motion and an appropriate level of resistance. As tolerance improves, exercises can be progressed gradually to help the shoulder adapt over time. Contact the studio direct for details of the next block of Fitness Pilates.
Everyone’s symptoms and needs are different, so movements should be adapted to the individual.
Try these **gentle starters**, staying within a comfortable range:
– Pendulum: Lean on a table with your good arm; let the sore arm hang loose and gently sway it forwards/back and side to side.
– Table slides: Sit at a table with your hand on a cloth. Slide it forwards, leaning your body gently to bring the arm up; stop before it becomes sharply painful.
– Outward isometric press: Keep your elbow tucked against your side and bent 90°. Press the back of your hand gently against a wall or doorframe without letting your arm move.
– Shoulder-blade setting: Sit or stand tall and gently draw your shoulder blades back and down; don’t shrug.
Start with a few slow repetitions, once daily, and build gradually if symptoms don’t worsen overall. Mild discomfort can be okay, but stop if pain becomes sharp, notably increases, or stays worse afterwards. Keep the shoulder moving, but temporarily reduce repeated painful overhead activity.
Seek a GP or physiotherapist if it isn’t improving after a few weeks or is limiting everyday activities.
Sam Deans Qualified Experienced & Insured Fitness Consultant
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