Your rotator cuff is actually a group of 4 muscles that perform the majority of your shoulder movements.  these four muscles, (the supraspinatus, infraspinatus, teres minor and subscapularis muscles) lift and rotate your arm, as well as give your shoulder joint stability, holding the head of your humerus (the “ball” of your “ball and socket” shoulder joint) where it needs to stay while you are moving your arm. 

Shoulder impingement is one of the leading causes of shoulder pain, and it can lead to tendonitis and bursitis and even to rotator cuff tears.  It is called impingement because when the space is too small for your rotator cuff tendons to run through, the bones can actually pinch on the tendon, causing impingement.  this pinching most commonly happens when someone reaches out or overhead, because this is the position where this space is naturally smaller.  There are many reasons that this space could become even narrower, causing “impingement,” but most commonly it is due to either your acromion being hooked or hypertrophied (larger), or having bone spurs on the bones, narrowing that space.  Poor posture can also lead to increased impingement, because when your shoulders are forward and rounded they put more stress on these tendons and close off that space even further. 

When that space is narrower, every time you lift or raise your arm you can be pinching your rotator cuff tendon (most commonly the supraspinatus tendon) and rubbing it on the bone.  this may not hurt right away, however over time with repeated pinching or rubbing, the tendon or the bursae can become inflamed or irritated, leading to tendonitis or bursitis respectively.  this can start to become painful, and in turn starts a vicious circle because as it becomes inflamed the tendon takes up even more space, leading to further rubbing, and so on.  In addition to this, another vicious circle is created because as you stop using that arm due to pain, your rotator cuff muscles start to get weaker.  as this happens, they stop supporting your shoulder as well, allowing that humeral head to elevate more as you lift your arm, which causes even more impingement on that tendon.  as you can see this can be a progressive process that just worsens over time.

This is why it is important for people of all ages and fitness levels to keep some sort of shoulder strengthening in their weekly routine, as well as work on their posture.  having good posture, keeping your shoulders back instead of letting them round forward, can go a long way in preventing shoulder impingement.  In addition to that, keeping your rotator cuff strong will allow the shoulder to be held in its optimal position during reaching and overhead activities, which will also assist in preventing shoulder impingement. 

It is also important to see your doctor or physical therapist early on if you do start having shoulder pain, and not just assume it will go away.  as you can see, letting things progress will only lead to further damage and a longer recovery.   So take all of the preventative measures you can… strengthen the shoulder and strengthen your postural muscles!  and if you do have pain, consult your doctor or physical therapist sooner rather than later!

Check out our basic shoulder strengthening and intermediate shoulder strenghethening exercises to ensure proper form for recommended exercises to strengthen the shoulder muscles and postural muscles.