- Shoulder pain is one of the most common physical complaints. Depending on the cause of your shoulder pain, the symptoms are often very different. The advantage of this is that it is generally easy to make a diagnosis based on the symptoms and complaints you experience.So that’s what we’ll do.The most common shoulder pain diagnosis is shoulder bursitis, but this is rare. It does happen, and that’s why I’ll discuss it here, but it’s certainly not the most common cause of shoulder pain. This is often an overused or damaged muscle in your shoulder, causing radiating pain into your arm and hand, or hurting when you lie on your shoulder.
Fortunately, you can often treat your shoulder pain with targeted exercises. That is why I’ll describe exactly what the anatomy of the shoulder looks like, which shoulder pain symptoms I often see in practice, and which muscles or other structures can cause this shoulder pain. Then I describe the exercises with which you can treat your shoulder pain yourself. If your symptoms are not listed, please email me so I can add them.
So read on quickly.
The anatomy of the shoulder
Your upper arm and shoulder blade together form your shoulder joint. We call your upper arm the head of your shoulder and the shoulder blade the socket of the shoulder. It is a ball-and-socket joint, where mobility is the most important function.
When you move your shoulder, you actually move your entire shoulder girdle. When you lift your arm, your shoulder blade rotates over your ribs and your ribs and even your cervical vertebrae also rotate away a bit to create more space for your shoulder movements. In addition, your shoulder connects to your sternum via your collarbone, which must also rotate properly. We call this the acromioclavicular joint or AC joint.
When your neck and upper back are stiff, it can cause compression in your shoulder joint, which can lead to irritation of the shoulder muscles that run through the joint. The main muscles are your supraspinatus and infraspinatus. Your supraspinatus provides the strength of your shoulder and the infraspinatus provides stability of your shoulder. Below your shoulder blade is the subscapularis. This muscle ensures that your shoulder blade remains stable on your ribs. They are also known as rotator cuff muscles.
Shoulder pain can therefore not only be caused by problems in your shoulder, but also by problems in the shoulder girdle and surrounding joints.
To guarantee the stability of the shoulder, your shoulder contains a lot of muscles. All these muscles must work together in order for the shoulder to function properly. Several bursae surround these muscles to protect the muscles from the pressure that can develop in the shoulder joint. When the shoulder muscles are irritated or damaged, the bursa fills with fluid to protect the muscles. A filled bursa is often mistaken for bursitis, but it is not. With bursitis, an inflammatory reaction is clearly visible in the bursa, which is absent in a filled bursa. The complaints are also very different, as you will read later.
Causes and symptoms of shoulder pain
If something is not functioning properly somewhere in the shoulder, this can lead to shoulder pain. We can often determine the cause of your shoulder pain through the specific symptoms. I will now try to explain your shoulder pain based on various symptoms and prescribe the right exercises.
Severe shoulder pain, where the shoulder can no longer be moved at all.
Very intense shoulder pain can indicate 2 causes. This is either a frozen shoulder or bursitis. With bursitis, there is excruciating shoulder pain, where the arm cannot be moved more than 5 cm in any direction. Patients who have shoulder bursitis sleep sitting in a chair and rate their pain as 12 on a scale from 0 – 10. You can read all about the cause and treatment of shoulder bursitis here. It’s a rare condition. Usually, the bursa is only a little filled to protect an irritated muscle. Not the bursa but the muscle is the cause of your shoulder pain. This is sometimes confused by doctors.
A frozen shoulder is an overload complaint, in which the capsule in the shoulder becomes inflamed and shortens as a result. This ensures that you can hardly rotate your arm out or lift it above your head. The complaints often develop slowly, in which we distinguish 3 phases:
Phase 1 is the inflammatory phase. In this phase, the shoulder becomes increasingly painful
Phase 2 is the freezing phase. In this phase, the shoulder becomes increasingly stiff, but also slowly becomes less painful.
Phase 3 is the defrosting phase. In this phase, the shoulder becomes more and more flexible and the complaints slowly disappear.
This process can take up to 1 or 2 years. The only thing you can really do about this is to rest your arm and not move too much through the pain. You can’t actually solve this yourself. For this, I would advise going to a physiotherapist.
Shoulder pain radiating down your arm to your fingers
Shoulder pain radiating down the arm to the fingers can have 2 causes. A nerve compression in your neck or an overload of your infraspinatus can cause pain and radiation. When the symptoms come from your neck, the radiation increases when you look upwards. You’ll also feel radiation toward your shoulder blade. For this complaint, perform the exercises against neck pain.
Looking up doesn’t aggravate the symptoms, it’s more likely that it’s coming from the infraspinatus muscle. Your infraspinatus is a shoulder muscle that lies on your shoulder blade runs through your shoulder and then attaches to the front of your shoulder. It stabilizes your shoulder, especially when your arm has no support, such as when driving a car. The radiance often runs towards your thumb. it can also cause a tired feeling in your arm. This can also cause shoulder pain when you lie on your side while sleeping at night.
To treat this cause of shoulder pain, perform exercises 1, 2, 5, and 6.
Pain in front of the shoulder and upper arm
Pain in the front of your shoulder and upper arm can also have 2 causes. The most common cause is an overload of your supraspinatus. The supraspinatus lies on top of your shoulder blade and runs
through your shoulder joint to the front of your upper arm. It ensures that you can lift your arm above shoulder height in front of you and sideways.
When your supraspinatus is not strong enough or is overloaded, it can become a bit thicker. This causes it to get stuck in your shoulder joint. This causes pain, especially at the front of your shoulder at the attachment, with radiation to the outside of your upper arm. You have trouble lifting your arm and doing things above shoulder height. Everything underhand is no problem. A stiff neck can also cause the supraspinatus to be impinged. Therefore this type of shoulder pain is also referred to as shoulder impingement syndrome.
For this cause of shoulder pain, perform exercises 1, 2, and 4.
Another possible cause of front and upper arm shoulder pain is an irritation of your biceps. This is the muscle that runs across your upper arm and allows you to bend your arm. When this is the cause, you have trouble lifting a heavy bag by bending your elbow. You can feel the pain from your shoulder to your elbow.
Pain in the back of the shoulder
Pain in the back of the shoulder can be caused by the infraspinatus that lies on the shoulder blade, by one of the ribs that lie below the shoulder blade, or by one of the back muscles that run between your back and shoulder blade. It depends on the location of the pain.
When the infraspinatus causes the pain, you feel a tired feeling on your shoulder blade, sometimes radiating to the front of your shoulder and into your arm and hand. It causes pain at night when lying on your side and when your arm is unsupported for long periods, such as while driving.
When your ribs are causing the pain, you will feel the pain extending from the back of your shoulder and back to your chest. Turning your upper back in particular is painful and limited, but shoulder movements do not aggravate the pain.
If the pain in the back of your shoulder is a problem of the back muscles, you will feel it especially when lifting and when you lift your arms to do something above your head. These complaints are often accompanied by a stiff upper back.
For this cause of shoulder pain, perform exercises 1, 2, 3, 5, and 6. You can also try the exercises for back pain for this.
Pain in the front of the shoulder and collarbone
Pain in the front of your shoulder and collarbone can be caused by a limited AC joint or stiff chest muscles.
A limited AC joint ensures that you cannot lift your arm completely overhand and sideways. In addition, putting your arm on your back is very painful and limited and you have difficulty moving your arm in front of your body.
Stiff chest muscles mainly cause pain when you press on the muscle and when you ‘stretch’ your arm up and backward. In addition, lifting can be painful and the pain sometimes radiates into your arm and hand.
For this cause of shoulder pain, perform exercises 3 and 6.
Shoulder pain treatment with 6 exercises
Below I describe the exercises you can perform for the different causes of shoulder pain. The exercises aim to increase the mobility of the shoulder and strengthen the affected muscles.
Do especially the exercises I mentioned above for your symptoms. You can do other exercises as long as they don’t make your pain worse.
To immediately relieve your pain, you can use an anti-inflammatory cream. This ensures that the pain decreases, making moving and exercising easier and promoting recovery.
You can also massage the painful areas yourself. This also ensures muscle recovery and decreases pain.
Shoulder pain exercise 1: Improve the mobility of your neck
The first thing you have to improve is the mobility of your neck. A stiff neck reduces the movements of your shoulder significantly. That’s one of the reasons why neck pain and shoulder pain often occur together.
When you can improve the mobility of your neck, you’ll see an immediate decrease in your shoulder pain. That’s because the compression of the rotator cuff muscles reduces directly due to the improved mobility.
Perform the exercise like this:
Wrap a towel around your neck
- Take with your left hand the right side of the towel and with your right hand the left side
- Now lift the hand that is in front up until the towel is at the same height as your cheek
- Now pull with your arm and the towel your head in the full rotation to the side
- Repeat this ten times and then change to the opposite side by changing your hands
- Finally, grasp the towel normal and lift your arms and look up at the same time
You can see how to perform the exercise in this video.
Perform this exercise twice a day, both in the morning and in the evening. Try to rotate your neck as far as you can. It may hurt a little bit, but that’s no problem.
Shoulder pain exercise 2: Improve the mobility of your upper back
The mobility of your upper back also influences your shoulder movements due to its connection to your rib cage. That’s why a stiff back also causes shoulder pain.
To perform this exercise you’ll have to buy this back stretcher.
By laying over this back stretcher. You’ll feel that your spine stretches and loosens up. You can also use it to stretch your lower back and reduce neck pain.
Lay down on it for about 20 minutes and several times a day. You’ll feel a significant difference within a week or so.
Shoulder pain exercise 3: Stabilize your shoulder blade
The third exercise you have to do is to improve the strength and function of your subscapular muscle.
By doing this, your shoulder blade moves better with your shoulder, resulting in less overuse of your rotator cuff muscles.
Perform the exercise like this:
- Place your hands at shoulder width against the wall at chest height
- Slowly bend through your arms towards the wall
- Slowly push of the wall again
- Repeat this exercise 15 times
- Do this 3 times
You can see how to perform the exercise in this video.
You’ll probably feel a difference between your left and right side. When the exercise becomes easy, you can also do regular push-ups. They have the same effect.
Shoulder pain exercise 4: Train your supraspinatus muscle
With these first three exercises, everything is set to improve your rotator cuff muscles to get rid of your shoulder pain.
The most often irritated muscle is the supraspinatus muscle. Supraspinatus tendinitis can cause a lot of pain and discomfort.
The function of your supraspinatus muscle is to lift your arm and guide your forearm alongside your shoulder blade.
When you have a shoulder injury, this movement can be excruciating.
Perform the exercise like this:
- Lift up both your arms sideways until it starts to hurt
- Slowly lower them again
- Repeat this 10 times
- Do this 3 times
You can see how to perform the exercise in this video.
Repeat this exercise twice a day. Don’t try to push the movement through the pain as this will only cause more problems. You’ll notice that you can go a bit further every single day until you reached full range of motion again.
At this point, you can use weights to gain even more muscle strength.
Shoulder pain exercise 5: Train your infraspinatus
The final exercise trains your infraspinatus muscle.
It is the other rotator cuff muscle that often causes shoulder pain. It performs outer rotation of your shoulder and also stabilizes your shoulder joint itself.
Perform the exercise like this:
Lay down on your healthy side with your painful arm pushed in your side
- Keep your arm flexed in 90 degrees
- Now rotate your arm so that your hand faces the ceiling
- Repeat this ten times and do this three times
You can see how to perform the exercise in this video.
Perform the exercise twice a day. You can increase the repetitions to 15 and even add some weight when it becomes too easy.
Shoulder pain exercise 6: Improving AC joint mobility
This exercise is designed to increase the range of motion of your AC joint. The exercise also stretches the infraspinatus and therefore works in 2 ways.
The exercise looks like this:
- Move your painful arm horizontally in front of your body
- Wrap your other arm around your elbow
- Pull your sore arm toward your body
- Hold this for 20 seconds
- Repeat this 3 times
You can also find the performance of the exercise in this video.
Perform the exercise several times a day to reduce pain in your AC joint and tension in your infraspinatus.
Conclusion
This shoulder pain treatment plan is easy to perform and helps for many types and causes of shoulder pain. If you have any questions left after reading this post, feel free to ask them by sending me an e-mail. Good luck with your recovery.
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