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Shoulder impingement syndrome (SIS) is a common cause of shoulder pain that affects many individuals, especially those engaged in repetitive overhead activities. If you happen to be an athlete or someone who frequently works with their arms raised, it's important to understand how SIS develops and which treatment options are best for it.

What is Shoulder Impingement Syndrome?

SIS occurs when the shoulder's soft tissues–such as the rotator cuff tendons–become compressed or “impinged” between the bones. This can lead to pain, inflammation, and decreased range of motion. If left untreated, SIS can result in more severe conditions like a rotator cuff tear.

SIS may be caused by one or more of the following: narrowing of an area within the shoulder called the subacromial space, abnormal motion of the shoulder, or muscle weakness. Patients who develop SIS typically experience pain when lifting the arm, weakness in the shoulder, a reduced range of motion, and/or discomfort when performing activities involving overhead motion.

Effective Treatments for SIS

The best way to treat SIS is through a combination of physical therapy interventions. Recent research has shown that a combination of manual therapy and therapeutic exercise leads to beneficial outcomes.

• Therapeutic exercise: Strengthening and stretching exercises help improve shoulder function and reduce pain. These exercises target the muscles around the shoulder to restore balance and support proper movement.


• Manual therapy: This encompasses a variety of hands–on techniques performed by a therapist to improve mobility and reduce pain. Manual therapy can also enhance capsular extensibility–the ability of the joint capsule to stretch–which allows the shoulder to move more easily.

The Study: Manual Therapy and Exercise Combined

A recently–published study examined the effects of combining manual therapy with exercise therapy on patients with SIS. Thirty–two participants with chronic SIS were divided into two groups: one received only stretching and strengthening exercises only (control group), while the other received manual therapy in addition to these exercises (treatment group). Sessions lasted 45 minutes for the treatment group and 30 minutes for the control group and took place five days per week for four weeks. All patients were assessed for pain, flexibility, and shoulder function with various rating tools before the intervention and then again after it was completed.

Results: The treatment group reported greater improvements in pain, functional capacity, and shoulder range of motion than the control group. The findings suggest that combining manual therapy with therapeutic exercise is more effective than exercise alone.

Benefits of Combining Therapies

Based on these findings, it appears that adding manual therapy to therapeutic exercise offers numerous benefits:

• Pain reduction: Manual therapy helps alleviate pain, making it easier to perform exercises.


• Improved mobility: Stretching and strengthening exercises restore range of motion.


• Enhanced function: Patients regain better control and function of their shoulders, leading to improved quality of life.

For additional details on this study, refer to the original publication
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Contact Us to Get Started on Your Path to Shoulder Relief

If you're experiencing shoulder pain or have been diagnosed with SIS, it's best to see a physical therapist who will combine manual therapy and a personalized exercise program to significantly improve your condition. Contact us today to learn more or schedule an appointment.