Shoulder pain can be confusing — especially when it hurts to lift your arm but you’re not sure why.
Is it impingement? A rotator cuff injury? Or something else entirely?
At RX Rehab & Performance in Pacific Beach, these are two of the most common conditions we see. They feel similar but come from slightly different problems — and the treatment plan depends on knowing which one you’re dealing with.
1. The Shoulder’s Design: Strength and Freedom
Your shoulder is built for motion. It relies on a delicate balance between mobility and stability to reach overhead, press, or throw.
The rotator cuff — a group of four small muscles — keeps the shoulder joint centered in its socket as you move.
When those muscles get overworked or when the joint loses its rhythm, tissues can start to rub or pinch, leading to pain that feels sharp or deep.
2. What Shoulder Impingement Feels Like
Impingement happens when soft tissues (like a tendon or bursa) get pinched between bones during arm movement.
It usually feels like:
- A sharp pain when raising your arm above shoulder level.
- Discomfort reaching behind your back.
- Relief when lowering the arm or resting.
You might feel fine at rest but get pain when pressing, swimming, or doing overhead movements.
3. What Rotator Cuff Pain Feels Like
Rotator cuff pain is often deeper and more constant.
Instead of a pinch, it feels like weakness or soreness in the upper arm or shoulder.
You might notice:
- Difficulty lifting even light weight overhead.
- Pain when sleeping on the affected side.
- Clicking or catching with certain motions.
Sometimes both conditions overlap — the cuff becomes irritated, which then causes impingement symptoms.
4. The Key Differences
| Feature | Shoulder Impingement | Rotator Cuff Pain |
| Pain Trigger | Lifting arm overhead or reaching back | Using arm against resistance |
| Location | Front or top of shoulder | Deep in shoulder or upper arm |
| Rest Pain | Usually minimal | May ache at rest or night |
| Weakness | Mild | Noticeable, especially with lifting |
| Primary Cause | Poor movement mechanics | Overuse or small tendon strain |
Understanding the difference helps target the right fix — movement correction vs. progressive strength loading.
5. What Not to Do
- Don’t keep forcing through pain — that often worsens irritation.
- Avoid endless stretching of the front shoulder; it’s usually already over-worked.
- Skip long rest periods — controlled movement heals faster than inactivity.
6. What Actually Helps
For both impingement and rotator cuff issues, the goal is the same: calm irritation, restore movement, and rebuild control.
Start with gentle pain-free mobility:
- Pendulum Swings: Relaxed arm circles help relieve stiffness.
- Scapular Retraction Drills: Teach the shoulder blade to move correctly.
Then add progressive strengthening once pain decreases:
- Isometric Rotations (pushing into a wall without moving)
- Side-lying External Rotations
- Wall Slides to retrain upward motion
These drills re-educate the shoulder to move smoothly without friction.
7. How We Treat Shoulder Pain at RX Rehab & Performance
We combine hands-on therapy with customized exercise progressions based on your exact pain pattern.
Our Pacific Beach team focuses on:
- Joint mobilization to restore motion.
- Soft tissue release for tight or overactive muscles.
- Strength and control training for the rotator cuff and scapula.
- Education on lifting technique and recovery pacing.
Patients from La Jolla, Bird Rock, and Clairemont often see significant improvement within a few weeks once they stop chasing symptoms and start retraining function.
8. Keeping Your Shoulders Strong Long-Term
- Warm up with light band work before upper-body sessions.
- Balance pressing and pulling in your workouts.
- Strengthen the rotator cuff weekly — light, consistent work goes a long way.
- Avoid “shoulder day only” routines — total-body strength supports joint health.
FAQ
Q1: How do I know if I have shoulder impingement or a rotator cuff injury?
Impingement hurts when raising the arm; cuff injuries cause deeper pain and weakness.
Q2: Should I rest or exercise with shoulder pain?
Gentle, guided movement is better than full rest — it speeds up healing.
Q3: Can I still lift weights with shoulder impingement?
Yes, with modified angles and reduced loads under professional guidance.
Q4: How long does recovery take?
Most mild cases improve in 4–6 weeks with progressive loading.
Q5: Does chiropractic or physical therapy help shoulder impingement?
Absolutely — manual therapy plus corrective exercise restores pain-free motion faster than rest alone.
Conclusion
Shoulder impingement and rotator cuff pain may sound different, but they share one solution: restore balance between motion and control.
At RX Rehab & Performance, we help athletes and active adults across Pacific Beach and La Jolla fix shoulder pain at its source — so you can lift, train, and move with confidence again.
