Download a Free Shoulder Impingement Exercises PDF

Shoulder impingement accounts for 44 to 65 percent of shoulder pain cases, making it one of the most prevalent musculoskeletal conditions encountered in clinical practice.¹ Effective management of shoulder pain requires more than a standard exercise prescription—it requires an informed approach that addresses the underlying biomechanical dysfunctions contributing to the pathology.

As a clinician, you know that successful treatment hinges on addressing the root causes of impingement. Integrating an evidence-based home exercise program into your practice is essential for long-term success. That’s why we’ve created a shoulder impingement exercises PDF—designed to reinforce in-clinic education and support patient adherence. Tools like this ensure patients perform their exercises correctly, reducing variability and improving outcomes.²

In this article, we’ll explore the key aspects of shoulder impingement, outline exercises to avoid, and dive into five essential exercises to include in your patient care plans. Get started today and download your free, printable shoulder impingement exercises PDF below.

Key considerations in shoulder impingement management

While the mechanical explanation of shoulder impingement may seem straightforward, contributing factors such as poor scapular mechanics, muscle imbalances, and repetitive overhead activities often complicate treatment. Effectively managing these issues requires a comprehensive, tailored approach that combines individualized assessments and targeted interventions. Below, we’ll explore strategies to optimize your clinical care for shoulder impingement before introducing specific exercises to include in your treatment plans.

1. The importance of early intervention

Identifying and treating shoulder impingement early is essential for maintaining shoulder function and reducing the risk of rotator cuff injuries. Research highlights that chronic impingement often leads to degenerative changes in the rotator cuff tendons,¹ increasing the likelihood of partial or full-thickness tears. Clinical assessments for diagnosing shoulder impingement, such as the Hawkins-Kennedy test, Neer’s test, and scapular dyskinesis evaluation, should be used to identify movement impairments in patients with shoulder pain and to tailor interventions accordingly.

Early intervention also helps build patient trust by demonstrating a proactive and attentive approach to care, positioning you as a reliable partner in their recovery journey.

2. Comprehensive assessment drives treatment

Beyond symptomatic relief, treatment should focus on restoring scapular mechanics and muscular balance. Studies indicate that patients with shoulder impingement often exhibit decreased lower trapezius activation and excessive upper trapezius dominance, leading to dysfunctional scapular upward rotation.³ Identifying deficits in scapular stability or specific muscular weaknesses allows you to focus treatment on the areas that will have the most impact on each patient, making your care more personalized and effective.

3. The role of patient education in adherence

Adherence to a structured rehabilitation program is essential for positive patient outcomes. Providing patients with a well-structured, easy-to-follow home exercise program has been shown to improve engagement and outcomes.² Our shoulder impingement exercises PDF is a clinically validated tool that enhances patient adherence by offering visual guidance and structured progression.

Providing robust patient education also reduces the likelihood of patients engaging in activities that may aggravate their condition. The more informed your patients are, the more empowered they feel to actively participate in their recovery.

Shoulder impingement exercises to avoid–and why

While exercises are critical for recovery, certain movements can exacerbate impingement symptoms and hinder progress. Some exercises can be modified or temporarily avoided to help keep your patients moving and on the road to recovery. Here are some common movements to avoid and why:

• Overhead pressing: Activities like military presses or overhead barbell lifts can significantly increase compression in the subacromial space. These exercises force the rotator cuff tendons into a position of vulnerability, leading to increased pain and inflammation. 

  • If your patient’s symptoms worsen with these types of movements, offer a neutral-grip alternative like the landmine press. This exercise uses a neutral pressing angle, which may make overhead pressing more tolerable while continuing to build shoulder strength. 

• Full-range bench pressing: Excessive anterior translation of the humeral head as the shoulder moves into extension can aggravate impingement symptoms. Coach your patients in exercising within a modified range of motion as appropriate.

  • Recommend alternative exercises that maintain the shoulders in a flexed to neutral position, such as the floor press.

• Lat pulldowns behind the neck: This position requires a greater range of shoulder external rotation, which may be limited or painful for patients with impingement-related symptoms. 

  • Suggest front lat pulldowns or rowing exercise variations that maintain neutral shoulder alignment as alternatives to build posterior shoulder strength.

By guiding your patients toward shoulder impingement exercises to avoid, you help protect the shoulder from further irritation while creating a structured path to recovery. 

Why use the shoulder impingement exercises PDF

Providing patients with the right tools is essential for a successful recovery. Here’s how integrating the handout into your practice can help:

• Improves adherence: Patients are more likely to follow a program when it’s clear and easy to access. The shoulder impingement exercises PDF provides structured guidance, reducing confusion and making home exercises more manageable.

• Promotes consistency: Standardized instructions help ensure patients perform exercises correctly every time, minimizing variability and reducing the risk of setbacks.

• Builds independence: Empowering patients to manage their recovery independently is critical for long-term success. The shoulder impingement exercises PDF provides a reliable, easy-to-use reference that helps patients feel confident in their ability to perform exercises correctly at home.

When to use the shoulder impingement exercises PDF

Here's when you can use the handout in your patient care:

• At the initial evaluation: Provide the PDF during the first visit to set clear expectations for home exercises and reinforce in-clinic instruction.

• In telehealth sessions: Telehealth visits can sometimes lack the hands-on guidance of in-person sessions, but a digital copy of the shoulder impingement exercises PDF can bridge that gap. Providing your patient with a resource they can refer to during or after your virtual consultation ensures they perform their exercises correctly.

• As a clinic handout: Offer the PDF to patients needing extra support between visits, using it to review techniques, troubleshoot challenges, and reinforce adherence.

How to use the shoulder impingement exercises PDF

The shoulder impingement exercises handout is a practical tool to help patients stay consistent with their home programs. Here’s how to make the most of it:

• Demonstrate exercises in session: Walk patients through each movement, ensuring proper form and technique. Use this opportunity to provide feedback, correct errors, and address any concerns to build their confidence in performing the exercises at home.

• Share the PDF digitally or as a printout: Print copies for patients who prefer tangible materials or share a digital version for easy access on their devices.

• Incorporate it into follow-ups:  Reference the shoulder impingement exercises PDF during check-ins to assess progress, refine exercises, and adjust the plan as needed.

5 exercises for shoulder impingement rehabilitation

Here are five evidence-based exercises to share with your patients:

1. Shoulder external rotation with anchored resistance

2. Shoulder internal rotation with resistance

3. Shoulder extension with resistance (neutral)

4. Standing shoulder scaption

5. Cat cow

These exercises target key muscle groups and movement patterns essential for addressing shoulder impingement. They focus on improving scapular stability, enhancing rotator cuff strength, and increasing thoracic mobility—critical elements in reducing pain, restoring function, and preventing recurrence. Each of these exercises is included in the shoulder impingement exercises PDF, providing your patients with clear instructions and visual aids to ensure they stay on track at home.

Let’s take a closer look at how these exercises work and how to guide your patients in performing them.

1. Shoulder external rotation with anchored resistance

• Why it works: Targets the infraspinatus and teres minor, which are essential for humeral head stabilization and reducing impingement-related compression in the subacromial space.

• Clinical tip: Encourage patients to maintain a neutral wrist and elbow position while keeping their arm close to the torso to minimize compensatory movements. Using a towel under the arm can help reinforce proper positioning and prevent excessive shoulder elevation.

2. Shoulder internal rotation with resistance

• Why it works: Strengthens the subscapularis, a key stabilizer of the glenohumeral joint, promoting balanced rotator cuff function and reducing anterior shoulder strain.

• Clinical tip: For this exercise, you can also use a towel under the arm to maintain a neutral wrist and elbow position. Additionally, cue the patient to keep their shoulder blades gently squeezed together, avoiding letting the shoulder roll forward during the motion.  

3. Shoulder extension with resistance (neutral)

• Why it works: Enhances lower trapezius and rhomboid activation, improving dysfunctional scapular mechanics. 

• Clinical tip: To avoid excessive upper trapezius recruitment, cue patients to draw their shoulder blades ‘down and back’ towards the end of the motion.

4. Standing shoulder scaption

• Why it works: Allows the patient to work on supraspinatus strength and shoulder elevation while minimizing compensation with the upper trapezius—aka ‘shoulder hike’. 

• Clinical tip: Cue patients to keep their thumb pointed up towards the ceiling, keeping the shoulder in an externally rotated position throughout the motion. 

5. Cat cow

• Why it works: Improves thoracic extension and flexion, which can enable better scapular and shoulder mechanics. It also activates the serratus anterior, which helps drive scapular upward rotation.

• Clinical tip: Integrate deep breathing to enhance mobility and patient body awareness.

Advancing clinical excellence in shoulder impingement care

Physical therapists play a pivotal role in optimizing shoulder impingement treatment through early intervention, customized movement assessment, and evidence-based exercise prescription. By incorporating targeted interventions clinicians can help patients reduce their shoulder pain and improve long-term shoulder function.

To streamline your patient education and treatment planning, download the free shoulder impingement exercises PDF today.

References

1. Creech, J. A., & Silver, S. (2023). Shoulder Impingement Syndrome. In StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/32119405/

2. Cools, A. M., Struyf, F., De Mey, K., Maenhout, A., Castelein, B., & Cagnie, B. (2014). Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. British journal of sports medicine, 48(8), 692–697. https://doi.org/10.1136/bjsports-2013-092148

3. Ludewig, P. M., & Braman, J. P. (2011). Shoulder impingement: biomechanical considerations in rehabilitation. Manual therapy, 16(1), 33–39. https://doi.org/10.1016/j.math.2010.08.004