Shoulder impingement syndrome is a painful condition of the upper extremity resulting from a structural narrowing of the subacromial space.
https://www.ncbi.nlm.nih.gov/books/NBK554518/This is a direct cause of rotator cuff tendon injury. Since I have recent experience in the area...
there are two main areas of thought in how to remedy.
1- Traditional physical therapy to both strengthen the muscle/tendon (1 of 4 is primarily the problem here), but even more importantly to strengthen the back muscles around the scapula and shoulder area which often are weaker than the front (pectorals etc). You see a lot of gym rats with impressive bench press capabilities that have their shoulders sort of hunched forward, which results in the shoulder being at the front of the socket. This aggravates the rubbing against the acoacromial arch. So this traditional therapy aims to stretch out the front muscles and simultaneously strengthen the rear muscles to move the arm ball back in the joint just a bit. If you have that hunched forward poor posture - this is you (and me).
2- More recently there is a progressive school of thinking that passive hanging will stretch out the acoarcromial arch to where it belongs, providing additional space for the rotator cuff tendons to pass underneath. I've been doing this since my injury and it can be a real help to reduce or eliminate the friction. For nearly all humans, because we give up hanging sometime after elementary school playground time, this joint settles down until impingement occurs. So nearly all of us would benefit by passive hanging.
This strategy was identified and described by Dr. John M. Kirsch, MD, who literally wrote the book on the subject. If you go to YouTube you'll find dozens of videos by physical therapists describing the simple exercise, all based on Kirch's work. So easy to do if you have a chin-up bar left over from when the kids were in the house.
1- Passive hanging directly
