EPISODE 68: Understanding Shoulder Impingement: Why Athletes Develop Shoulder Pain

By Dr. Maile Bay Jacques & Dr. Ja'nae Brown

For athletes and active individuals, shoulder pain can be more than just an annoyance — it can limit performance, disrupt training, and keep you out of the activities you enjoy most. Whether you’re throwing, swimming, lifting, climbing, or participating in overhead sports, your shoulders are constantly exposed to high demands and repetitive stress.

One of the most common causes of shoulder pain in athletes is shoulder impingement, a condition where the rotator cuff tendons and surrounding tissues become irritated or compressed during movement.

Many athletes first notice symptoms as pain during overhead motions, weakness while lifting, loss of power, or lingering soreness after training sessions. Unfortunately, trying to “push through” the discomfort often leads to worsening irritation and decreased performance over time.

The good news? Shoulder impingement is highly treatable. With the right rehabilitation plan, most athletes can safely return to training and competition stronger and more resilient than before.

At Physical Therapy San Pedro, our goal is not only to reduce pain, but also to identify the underlying mobility, strength, and movement deficits contributing to the problem so athletes can move well, perform well, and stay healthy long term.

What Is Shoulder Impingement?

The shoulder is one of the most mobile joints in the body, allowing athletes to perform powerful overhead movements through extreme ranges of motion. However, that mobility also makes the shoulder heavily dependent on muscular control and movement coordination.

Shoulder impingement occurs when structures within the shoulder — most commonly the rotator cuff tendons and subacromial bursa — become compressed or irritated during movement.

The shoulder joint itself is made up of several structures working together:

• Glenohumeral joint — where the upper arm bone meets the shoulder socket

• Acromion — a bony structure that sits above the shoulder joint

• Subacromial space — the area where important soft tissues pass through

• Rotator cuff muscles — a group of muscles responsible for stabilizing and controlling shoulder movement

When shoulder mechanics break down due to weakness, stiffness, fatigue, or overload, the available space inside the joint decreases, leading to irritation and pain.

Common Causes of Shoulder Impingement

Shoulder impingement rarely develops from a single event. In athletes, it is usually the result of repetitive stress, poor movement mechanics, muscular imbalances, or training overload over time.

Repetitive Overhead Activity

Sports and activities involving repeated overhead motion place high demands on the shoulder, including:

• Throwing sports

• Swimming

• Volleyball

• Tennis

• Weightlifting

• CrossFit

Over time, repetitive loading can irritate the rotator cuff tendons and surrounding tissues.

Rotator Cuff Weakness

The rotator cuff helps stabilize the shoulder during movement. Weakness or fatigue can allow the shoulder joint to move inefficiently, increasing compression and irritation.

Poor Scapular Control

The shoulder blade acts as the foundation for overhead movement. Poor scapular stability or coordination can alter shoulder mechanics and increase stress on the rotator cuff.

Limited Mobility

Stiffness in the thoracic spine, chest muscles, or posterior shoulder capsule can restrict movement and force the shoulder to compensate during overhead activities.

Training Errors

Sudden increases in:

• Training volume

• Intensity

• Frequency

• Overhead pressing

• Throwing volume

can overload tissues faster than the body can recover.

Faulty Technique & Movement Mechanics

Poor lifting form, throwing mechanics, or overhead positioning can repeatedly place the shoulder in compromised positions and contribute to long-term irritation.

Symptoms of Shoulder Impingement

Shoulder impingement symptoms often develop gradually rather than from one traumatic injury. Athletes may initially notice mild irritation before symptoms progress into more persistent pain that affects performance and recovery.

Common Symptoms Include:

• Pain during overhead activity

• Pinching sensation when lifting the arm

• Weakness or loss of power

• Fatigue during workouts

• Soreness after training

• Difficulty sleeping on the affected side

• Clicking or popping sensations

• Limited mobility or stiffness

• Pain during specific exercises or positions

Many athletes continue training despite symptoms because the pain may only occur during certain movements. However, untreated shoulder impingement can worsen over time and eventually impact overall athletic performance.

When Should You Seek Medical Attention?

Mild shoulder soreness after hard training can be normal, but persistent or worsening pain should not be ignored.

You should seek evaluation if you experience:

• Shoulder pain lasting several weeks

• Pain that worsens over time

• Loss of strength or mobility

• Difficulty throwing, lifting, or swimming

• Pain interfering with sleep

• Feelings of instability or the shoulder “giving out”

• Symptoms after a fall or traumatic injury

• Recurring shoulder pain despite rest

Early treatment often leads to faster recovery and helps prevent minor irritation from becoming a more significant injury.

Recovery Timeline for Shoulder Impingement

Recovery time varies depending on:

• Severity of symptoms

• Duration of irritation

• Training demands

• Underlying strength or mobility deficits

In mild cases, athletes may improve within a few weeks after modifying aggravating activities and beginning rehabilitation. Moderate cases often require 6–12 weeks of structured rehab. Chronic or longstanding symptoms may take longer.

One of the biggest mistakes athletes make is returning to sport too quickly before the shoulder is fully prepared to tolerate high-level loading again.

Recovery is rarely perfectly linear. Some soreness during rehabilitation is normal, especially as training intensity increases. The goal is steady progress over time while restoring:

• Strength

• Mobility

• Stability

• Movement quality

• Confidence

Physical Therapy Treatment for Shoulder Impingement

Treatment for shoulder impingement focuses on reducing irritation, restoring normal movement mechanics, and safely returning athletes to training and sport.

Activity Modification

Athletes may temporarily need to reduce:

• Overhead lifting

• Throwing volume

• Pressing intensity

• Repetitive upper-body loading

This allows irritated tissues time to recover while maintaining overall movement and conditioning.

Physical Therapy

Physical therapy is one of the most effective conservative treatment options for shoulder impingement.

A comprehensive rehab program may include:

• Shoulder mobility work

• Rotator cuff strengthening

• Scapular stabilization

• Thoracic spine mobility

• Manual therapy

• Movement retraining

• Sport-specific progressions

Strength & Stability Training

The rotator cuff and scapular stabilizers play a major role in shoulder control and durability. Strengthening these muscles improves joint stability and movement efficiency.

Movement Re-Education

Improving lifting mechanics, throwing technique, and overhead positioning helps reduce stress on the shoulder and prevent recurring symptoms.

Supportive Interventions

Additional tools may include:

• Ice

• Anti-inflammatory strategies

• Taping techniques

• Temporary load management

Injections or Surgery

In more severe cases, imaging or medical interventions such as corticosteroid injections may be recommended. Surgery is typically reserved for cases that fail conservative treatment or involve significant structural damage. Fortunately, most athletes improve successfully with non-surgical rehabilitation.

Final Thoughts

Shoulder impingement is one of the most common causes of shoulder pain in active individuals and athletes, but it is also highly treatable when addressed properly.

Successful recovery is about more than simply eliminating pain. It requires improving:

• Mobility

• Strength

• Shoulder control

• Movement quality

• Training load management

Struggling with an injury?

At Physical Therapy San Pedro, we help athletes return to sport safely by combining evidence-based rehabilitation with performance-focused training and movement analysis.

If shoulder pain is limiting your training or performance, our team is here to help you move better, recover confidently, and get back to doing what you love.

If you’re in the San Pedro or Los Angeles area and looking for some help, we are a practice that reflects these values — individualized care, intentional programming, and long-term performance. We’d love to work with you at Physical Therapy San Pedro.

For those outside the area, we also offer telehealth sessions and online programs focused on ankle and knee pain, designed for athletes who want to keep progressing no matter where they’re located.

Stay Connected & Take the Next Step

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Stay strong. Stay moving.

❤️ Dr. Bay & Dr. Brown