Shoulder impingement is a painful condition resulting from repetitive compression of soft tissues within the joint. This compression leads to irritation and inflammation of the tendons and bursa, causing pain during daily activities and exercise. Understanding which movements aggravate this condition is necessary for preventing further injury and managing discomfort. Modifying a workout routine involves avoiding specific exercises that force the shoulder into positions of maximal compression, allowing the inflamed structures to recover. This focuses on eliminating high-risk movements known to exacerbate the underlying irritation.
How Movement Causes Compression
The shoulder joint contains a narrow passageway known as the subacromial space, which sits beneath a bony structure called the acromion. Passing through this confined space are the tendons of the rotator cuff muscles, primarily the supraspinatus tendon, and the subacromial bursa. Impingement occurs when movements cause the head of the humerus (upper arm bone) to translate upward or forward, crowding this space and pinching these soft tissues against the overlying acromion.
This narrowing is often worsened by muscle imbalances, where the larger, stronger deltoid muscle overpowers the smaller rotator cuff group. When the rotator cuff is relatively weak, it fails to keep the humeral head properly centered and depressed during arm movement, leading to its superior migration. Poor posture, such as a rounded upper back or protracted shoulders, also contributes. This posture alters the natural movement and position of the scapula, which further limits the clearance in the subacromial space.
High-Risk Overhead Exercises
Exercises that involve raising the arm significantly above the shoulder level while under load are the most common cause of symptom flare-ups. These movements force the greatest reduction in the subacromial space, maximizing the chance of pinching the irritated tendon and bursa. The most frequently cited high-risk movement is the overhead press, including military or barbell presses, where the weight pushes the humeral head directly into the acromion at the top of the lift.
Lateral raises, when performed beyond 90 degrees of abduction (horizontal), also become problematic because this range of motion directly drives the compression mechanism. Similarly, any movement that involves pulling or pressing behind the neck, such as behind-the-neck pulldowns or presses, places the shoulder in an externally rotated and abducted position that is vulnerable.
This combination of movements creates strain on the rotator cuff and often exceeds the safe range of motion for a compromised shoulder. Pull-ups or lat pulldowns performed with a very wide grip can also contribute to compression, especially if the form involves excessive shoulder shrugging or protraction.
Loaded Internal Rotation and Compromised Positions
Movements that do not require maximum overhead reach can still provoke impingement by forcing the shoulder into an internally rotated or unstable position under load. The upright row is a prime example, as raising the elbows high while keeping the hands close together forces the humerus into internal rotation. This internally rotated position significantly narrows the subacromial space, making it a direct provocation test for many individuals with impingement.
Deep chest dips are another exercise that places the shoulder in a compromised state, combining extreme extension and internal rotation. As the body lowers, the shoulder joint is forced to an end-range position, which can cause the humeral head to translate forward and upward, creating anterior impingement.
Dumbbell or cable chest flyes, particularly those that allow the arms to stretch too far back, also risk anterior humeral head glide. This excessive stretch can destabilize the joint capsule and cause a migration of the humeral head that strains the tissues in the front of the shoulder. Compound movements like close-grip cable rows can also be problematic. This is because the grip naturally places the arm in an internally rotated position while under heavy tension.
Recognizing Pain Signals and When to Stop
The most identifiable symptom that indicates an exercise is aggravating impingement is the presence of the “painful arc.” This specific signal is a sharp, pinching pain that occurs when raising the arm sideways (abduction), typically appearing between 60 and 120 degrees of movement. The pain often lessens or disappears once the arm moves above the 120-degree mark or when it returns to the side of the body.
It is important to differentiate this sharp, localized joint or tendon pain from the generalized burning sensation of muscle fatigue. A sharp pinch or a deep, throbbing pain that persists, especially when lying on the affected side, is a clear warning sign that the exercise should be immediately stopped or modified.
If an exercise causes this pain, reduce the load or limit the range of motion to stay below the painful arc. Alternatively, select an entirely different movement that does not reproduce the symptoms.