Shoulder Impingement: What’s Really Happening in Your Shoulder

If you’ve ever felt a sharp pinch or ache in your shoulder when you reach overhead when you are grabbing something from a high shelf, putting on a jacket, or lifting weights, you’ve likely dealt with shoulder impingement.

At Backcountry Physical Therapy in Colorado Springs, we see shoulder impingement all the time, especially in Rocky Mountain athletes who climb, lift, ski, and train hard.

Here’s the thing: shoulder impingement isn’t a single problem. It’s a movement dysfunction with multiple causes and layers. Let’s break down what actually happens in your shoulder, what drives the issue, and how you can fix it for good with help from a physical therapist in Colorado Springs.

Quick Shoulder Anatomy

Your shoulder is the most mobile joint in the body and with that mobility comes vulnerability (or instability).

The shoulder joint (the glenohumeral joint) is a ball-and-socket joint made up of:

• The humerus (upper arm bone)
• The scapula (shoulder blade)
• The clavicle (collarbone)

Around these bones sit your rotator cuff muscles, four small but powerful stabilizers that keep the head of your humerus centered in the socket as you move. Above the joint is a bony roof called the acromion, and between that roof and the humerus lies a small space called the subacromial space.

Inside that space are critical tissues like the supraspinatus tendon (part of the rotator cuff) and the subacromial bursa, a fluid-filled sac that helps reduce friction.

When that space becomes irritated, swollen, or compressed, you get shoulder impingement syndrome, a painful pinching sensation during movement.

What Is Shoulder Impingement?

1. Shoulder impingement occurs when the tendons or bursa in the subacromial space become compressed or irritated during overhead or repetitive movements.
2. In simpler terms: something in your shoulder is rubbing or being pinched when it shouldn’t be.
3. There are two main types of impingement:
4. External (Subacromial) Impingement:
   • The rotator cuff tendons are pinched between the humeral head and the acromion.
   • Common in overhead athletes, lifters, and swimmers.
5. Internal Impingement:
   • The rotator cuff tendons are pinched against the back of the shoulder socket during extreme rotation (common in pitchers or climbers).

Common Symptoms of Shoulder Impingement

You might have impingement if you notice:

• A sharp or aching pain in the front or side of the shoulder
• Pain that worsens when reaching overhead, behind your back, or to the side
• Weakness when lifting objects
• Pain at night, especially when lying on the affected shoulder
• A “catching” or “pinching” sensation during motion

Symptoms often start mild and gradually worsen, especially if the root cause isn’t addressed.

Working toward pain relief in active individuals in Colorado Springs.

What Causes Shoulder Impingement?

Here's where things get interesting: impingement isn’t always the problem, it’s the symptom.

The real issue is often how your shoulder blade, rotator cuff, and posture are functioning together. Let’s look at the most common contributing factors and break it down from a physical therapy standpoint:

1. Poor Scapular Mechanics
   • Your shoulder blade (scapula) acts as the foundation for your shoulder joint. When it doesn’t move properly due to weakness, stiffness, or muscle imbalance, the shoulder joint mechanics are thrown off.
     Result: the humeral head moves upward excessively and compresses the rotator cuff tendons.
2. Rotator Cuff Weakness
   • The rotator cuff muscles stabilize your shoulder. When they’re weak or not activating properly, your larger muscles (like the deltoid) dominate, pulling the humeral head upward into the acromion.
   • Result: decreased subacromial space = more irritation.
3. Postural Changes
   • Rounded shoulders, forward head posture, and prolonged sitting all alter shoulder alignment.
   • Result: limited space for tendons and increased friction with every overhead motion.
4. Overuse or Repetitive Overhead Activity
   • Sports like climbing, swimming, tennis, or CrossFit involve repeated overhead motion that can cause irritation over time.
5. Tight Chest and Shoulder Muscles
   • When the pecs and front shoulder tissues get tight, they pull the shoulder forward, again reducing joint space.
6. Age-Related Changes
   • Over time, the rotator cuff tendons can weaken or fray, and the acromion bone may develop spurs that narrow the subacromial space.

Why Shoulder Impingement Isn’t Always “Impingement”

Here’s the truth: “shoulder impingement” is often used as a catch-all diagnosis for shoulder pain. Studies show that pain doesn’t always correlate with actual tissue impingement.

Sometimes, the pain comes from inflammation, tendon overload, or motor control issues, not a literal pinch.

That’s why individualized physical therapy assessment near Colorado Springs is so important. At Backcountry Physical Therapy, we don’t just treat the painful area, we identify the root cause and why it’s happening in the first place.

How We Assess Shoulder Impingement

Our evaluation process looks at your whole kinetic chain, not just your shoulder joint. Here’s what we typically assess:

• Posture and scapular control
• Rotator cuff strength and endurance
• Thoracic spine mobility
• Shoulder blade positioning during movement
• Functional movements like reaching, lifting, or pulling

This helps us uncover the underlying cause, whether it’s muscle imbalance, mobility restriction, or motor control deficit.

How to Fix and Prevent Shoulder Impingement

Once we know the cause, treatment focuses on restoring mobility, strength, and control through progressive movement.

• Restore Shoulder Blade Function
  • Your shoulder blade is the foundation. Exercises like quadruped “snow angels,” scapular push-ups, and wall slides retrain it to move in sync with the arm
• Strengthen the Rotator Cuff
  • Controlled, lightweight exercises like external rotations, side-lying raises, and band pull-aparts build the stabilizing strength that keeps your shoulder centered
• Improve Thoracic Mobility
  • If your upper back is stiff, your shoulder motion will suffer. Foam rolling, open-book stretches, and thoracic extensions can help restore mobility
• Address Posture
  • Improving posture through awareness and strength (especially in the upper back and posterior shoulder) helps keep the joint aligned
• Gradual Loading
  • As symptoms improve, we progressively reintroduce strength and overhead movement, like pressing, hanging, or sport-specific motions, with proper control and tempo
• Eccentric & Stability Training
  • Slowing down the lowering phase of lifts and adding stability work (like overhead carries or controlled lowering) improves resilience and tendon health

Why This Matters for Rocky Mountain Athletes

Colorado athletes stay active, strong, and constantly push their limits! Whether they’re climbing, skiing, lifting, or hiking with a heavy pack. Shoulder impingement can derail that lifestyle fast.

When athletes don’t control their shoulders and scapula well, overhead and load-bearing activities can irritate the joint and eventually cause rotator cuff tears.

That’s why, as physical therapists in Colorado Springs, we focus on building durability, not just relieving pain. We help athletes move confidently anywhere from the weight room to the mountains to everyday life.

When to See a Physical Therapist

If shoulder pain lasts longer than a week, interferes with daily activities, or limits your training, it’s time to get assessed.

At Backcountry Physical Therapy, we specialize in identifying the root cause of shoulder pain and building individualized programs to restore mobility, strength, and performance without relying on medications or quick fixes.

Because you deserve more than a temporary solution; you deserve a shoulder that moves freely and performs at its best.

Final Thoughts

Shoulder impingement isn’t just about a pinched tendon, it’s about how your shoulder, scapula, and thoracic spine work together.

By improving shoulder control, mobility, and strength, you can not only resolve impingement but also prevent future injury, so you can keep doing what you love, pain-free.

We help active people in Colorado Springs, Manitou Springs, Briargate, Falcon, Rockrimmon, and surrounding areas!

📞 Call us today or 📧 book your evaluation with us to get started with your Physical Therapy in Colorado Springs (719) 285-9670