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Swimmer’s shoulder. Physical therapy for shoulder impingement syndrome

frozen shoulder treatment miami

Can I swim if my shoulder hurts?

It’s pretty much always hot in Florida and a favorite pastime for most is some type of water-related activity – swimming, boating, kayaking, paddleboarding.

One question we get often here at Hands-on Therapy Services is…

If my shoulder hurts but I can move my arm… “Can I go swimming if my shoulder hurts?”

Technically….the short answer is yes….but here’s why it’s a bad idea.

If you have a shoulder impingement – or simply put, pain when raising your arms up and down – swimming may make it worse. Let me explain a little more about shoulder impingement in this blog post.


What is shoulder impingement syndrome?

Shoulder impingement is when the humeral head rubs against and the acromion part of the shoulder blade. It becomes a vicious cycle of rubbing and pinching the rotator cuff tendons that sit between the two parts of the bones.


Source: https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-impingementrotator-cuff-tendinitis 



When you raise your arms over your head, take your t-shirt off, reach behind your back, or reach to the back seat – your bones are supposed to clear and have room for those tendons to glide and move properly. When there is no room between the bones, over time the rubbing and pinching causes a painful shoulder problem called impingement syndrome.

Anyone with a shoulder is susceptible to developing shoulder impingement at some point in their life. Roughly 70% of people will develop shoulder problems at some point in their lives. Research shows that after the age of 40, you are more likely to start showing signs of shoulder pain or stiffness from wear and tear due to consistently using your shoulders.


What are shoulder impingement symptoms?

The majority of the time, the symptoms are shoulder pain with reaching overhead or reaching backward. You may feel a pinching type of pain that is sharp and radiates down your arm for a second. Then there is a dull achiness that lingers.

Long-standing shoulder impingement can lead to stiffness and even a “ frozen shoulder” where you start to lose even more motion. Especially motion to reach behind your back or behind your neck.

At first, the pain is once in a while. Over time, it can become more constant shoulder pain interfering with getting comfortable to sleep, and staying asleep. It can affect your ability to work out, be more active with sports, playing with your kids, or even staying active with activities you like doing around your house.

The #1 reason people call us at Hands-on Therapy Services is when they start having more shoulder pain when sleeping, or when they can’t sleep due to the pain.

You don’t have to wait until the pain is severe. Grab our Shoulder Pain Guide here and get started.


What causes shoulder impingement?

There are a variety of reasons why shoulder impingement can develop. If you are active with various sports, or workouts, or even do DIY projects around your house.  

Shoulder impingement can be due to an accident, fall onto an outstretched hand, prior surgery on the same arm.

Shoulder pain from impingement can be from overuse. It can be from a “wrong” movement that you never remember doing. Then over a long period of time, the capsule gets tight in certain places and the imbalances of your muscles then become painful.  

You can develop the pain from being pregnant! Having a baby does major changes to a woman’s body due to hormones that loosen the joints. Major rapid weight loss or gain can have impacts on your shoulders.  

Old injuries that are not fully taken care of, over time can cause shoulder impingement symptoms. Examples are hand and wrist injuries or surgery, elbow surgeries, and even back pain that was never fully 100% recovered.

Part of knowing what causes shoulder impingement is to empower yourself to get help to get rid of shoulder pain and shoulder impingement syndrome.


How serious is shoulder impingement?

At first, shoulder impingement is not a serious injury. It’s not like you fell and broke a bone “serious”.  

If not treated properly, left to continue to rub together, shoulder impingement can become very serious. From the rubbing of the tendon, and capsule getting tight – you can develop a rotator cuff tear. Which could require rotator cuff surgery.


Before getting to the point of surgery, you may go through stages.  

The first stage

The first stage is just starting to feel your shoulders achy, tight, or maybe once in a while a sharpness to the achiness. Most of the time, you can rub it out, get a massage, or it might even compel you to stretch a bit. And it may go away for a while.


The second stage

The second stage is when you start to feel the pinching type of pain only with certain movements. It may be an over the head time of reach or a reaching behind like grabbing something from the back car seat or clipping the back of your bra. The sharpness is there, then goes away and you are left with an achy shoulder. It becomes more and more uncomfortable and in certain cases, you may want to take pills to calm the pain down before it gets worse if you are working out, kayaking, or playing some sport like tennis.


The third stage

The third stage is when the pain becomes more constant. It’s hard to fall asleep, stay asleep, the pain may wake you up in the middle of the night. You might start to wonder if it’s from always sleeping on your favorite side. You will start to notice more loss of motion.  

At this point, you may decide to go to the doctor, get an MRI to “see what is really wrong”, and be offered an injection.  


The final stage

The final stage is when left untreated properly, the rotator cuff tendon is torn, and you have already exhausted your 2 shots of cortisone so that a surgeon recommends rotator cuff surgery for you to get rid of shoulder pain.

Before getting to the point of pills, injections, or surgery, the best way to treat shoulder impingement syndrome is through occupational/physical therapy.  

We hear this a lot at our clinic, and after 20+ of treating shoulders at these various stages, we know we can help you no matter what stage you are at.


How can occupational/physical treat shoulder impingement syndrome?

No matter what stage you come to occupational/physical therapy here at Hands-on Therapy Services, we can help.

We first determine through our unique way of evaluation, asking questions, looking at all of your movements, and clinical testing – help determine where the root cause of your problem may be.  

If you have never been to therapy or even if you have tried therapy before and did not get the outcome that you wanted, you may wonder what that looks like. Well, it’s a series of movements that we look for and test for muscle imbalances. It does require some hands-on to feel how your joints and muscles feel.  

Then we find out which movements and in what directions will be most effective for you to get started with.


People often ask – how long does it take to “heal” a shoulder impingement?  Based on the stage when you come, the severity of your symptoms, and how slow or fast you want to go, helps us to develop a plan with you.

If you think you may have shoulder impingement syndrome OR just have shoulder pain and you want to get rid of it, give us a call at 786-615-9879 or request a Free Discovery Visit. You don’t need to go to the doctor or get an MRI first.

Written by Hoang Tran


About the author – Hoang Tran

Hoang Tran is a Miami certified hand therapist , the owner of Hands-on Therapy Services and author of the book “The Hands-On Approach”. She loves helping people with hand, neck and shoulder problems, because she knows how bad and debilitating they can get if not addressed and treated properly (once and for all!).  

The aim of her occupational therapy practice in the Miami area is to bring patients back to full functionality, without pills, injections or surgery. Occupational and Physical Therapy are both offered at Hands-On Therapy by our experienced therapists who provide a comprehensive approach to your care.

If you are struggling with shoulder, neck pain or hand pain, including


or any other hand, elbow or neck injuries, speak with one of our specialists for FREE by signing up for a 30-minute Discovery Visit.

Even if you have tried other forms of treatment and are still NOT sure what’s going wrong and need better clarification on what can actually work to avoid the shoulder pain and impingement from becoming worse, there’s no risk in giving us a call at 786-615-9879 or requesting a Free Discovery Visit. 

A Discovery Visit is for someone who is not sure therapy with us can help them, wants to speak with the specialist to feel confident that therapy is the right choice for them, and is SURE they don’t want to live in pain, worry, and feeling like they can’t do certain things just because of the pain.

In these difficult times, we are here to help. Telehealth and online sessions are available!





The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.


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