A sore shoulder is a common complaint leading people to seek physical therapy exercises for shoulder pain. Many people describe symptoms of tightness, stiffness, or mobility loss with a shoulder injury. To identify what is potentially wrong, and how to best find relief from shoulder pain, it helps to have a solid understanding of this adaptable joint.
Shoulder Mechanics
The shoulder is the most flexible joint in the human body. Its highly mobile capability allows people to use their arms in amazingly functional ways. Interestingly, the shoulder is not just the ball and socket joint that most people know. In effect, it is several joints working together – the glenohumeral joint and the acromioclavicular joints- surrounded by many muscles, ligaments, and tendons, that combine to create an extremely stable, strong, and mobile shoulder.
Shoulder Pain Causes
With so many moving parts, so to speak, it is no surprise that there are many shoulder pain causes. Below we will discuss some of the most common conditions that create a painful shoulder.
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Shoulder Tendonitis
Tendonitis of the shoulder involves inflammation in one or more tendons, most often the biceps tendon or in the rotator cuff area. In general, symptoms can range from mild to severe and can create problems with arm movement, or even an ability to hold the arm in specific positions.
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Shoulder Bursitis
The bursa is a fluid-filled sac found in the shoulder joint that can become inflamed when there is joint friction. Sometimes this friction occurs as the joint surfaces change over time, and in other cases, a fall or injury can impact the joint alignment. No matter the underlying cause, shoulder bursitis is generally painful and can lead to swelling or warmth in the shoulder.
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Shoulder Osteoarthritis
Some people describe osteoarthritis as “wear and tear” of a joint over time. For this reason, shoulder osteoarthritis symptoms tend to present gradually, perhaps with a stiff feeling in the joint. As the cartilage and other tissues in the joint break down, pain generally increases, while mobility decreases.
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Frozen Shoulder
Frozen shoulder, also known as adhesive capsulitis, occurs when the connective tissue around the shoulder becomes inflamed, thick, and stiff. As pain increases, shoulder movement tends to decrease, and the shoulder becomes stuck in a cycle of joint immobility and pain.
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Rotator Cuff Tear
The rotator cuff is a group of muscles that surrounds the shoulder joint, helping to keep the alignment of the upper arm bone in the socket of the joint. Small tears can occur in one or more of the muscles from overuse, malalignment, or just age-related weakening. Large tears tend to be more traumatic in nature, for example from a fall or lifting something too heavy. In either case, people tend to complain of a dull ache in the shoulder, or discomfort when sleeping on the involved side.
5 Physical Therapy Exercises for Shoulder Pain
Certainly, there are many exercises that help to keep a shoulder healthy, flexible, and strong. By staying active and paying attention to the mobility and function of your shoulders, perhaps you can avoid shoulder pain in the first place.
Here are some common exercises to help keep your shoulders working well. Remember, however, that it is important to listen to your body’s cues. If anything causes sharp or increased pain, stop the exercise, and see a professional physical therapist for an evaluation.
Physical Therapy Exercise #1: Corner Stretch/Chest Expansion
Over time, many people develop a rounded posture that tightens the muscles in the front of the body. Notably, most people work with their arms in front of them: cooking, keyboarding, lifting, and so on. It is not uncommon for the front of the shoulder joint to tighten as well. A doorway stretch works to promote chest opening and helps stretch the muscles in the front of the shoulder.
- Find some wall space in an uncrowded corner of the room
- Place your elbows to forearms on the walls at 90°/90°, and gently lean your torso forward until you feel a gentle stretch at the front of your shoulder/upper chest
- Make sure you do not over arch your back
- Keep slow, deep breathing and hold for at least 30 seconds
- Repeat 2-3 times
Physical Therapy Exercise #2: Side-lying Rotation
Likewise, when the front of the shoulders gets tight, the back of the shoulders tends to get weak due to an imbalance of activity in front of the body. Strengthening the back of the shoulder, specifically the external rotators, can sometimes help with shoulder pain.
- Lay on your side on the floor (use a pillow or bolster to support your head and neck) with your elbow at a 90° angle, resting across your abdomen
- Slowly raise the fist up toward the ceiling, keeping the elbow glued to your side
- Hold for a few seconds at the top
- Slowly lower down, with control
- Gradually advance this with lightweight dumbbells to your tolerance
Physical Therapy Exercise #3: D2 Flexion with Theraband
The diagonal pattern of this exercise strengthens the entire shoulder region, including the posterior side.
Start with one end of the theraband secured below waist level. Grasp the end of the band with your elbow straight, with your hand at the opposite hip. Pull the theraband upward and away from your body. Hold and slowly return to the starting position. Keep a neutral spine and your core braced.
Physical Therapy Exercise #4: Forearm Plank or Plank
Sometimes hypermobility can create shoulder pain. To help increase overall shoulder stability, plank exercises can be helpful. Forearm plank is also effective, especially if you are prone to wrist strain.
- Assume a pushup position, making sure your shoulders align over your wrists. In the case of forearm plank, lower this to the forearms
- Hold this position for anywhere from 10-30 seconds, making sure not to hold your breath
- Be aware of your upper back posture, that it is not overly rounding, and that your low back is not swaying down to an arch
- Hold only as you can keep your spine aligned in a neutral position
- Rest and repeat
Physical Therapy Exercise #5: Neck Release
Several of the neck muscles attach in the shoulder area, so keeping the neck gently loose and aligned, can sometimes help with shoulder pain.
- Place one arm down by your side, and the opposite hand all the way across the top of the head, to just above the ear
- Gently tilt your head away from the hand that is down by your side
- The hand on your head guides your head and provides a little extra stretch, but the force should be slow and gentle
- Hold the stretch for 45 seconds, then repeat on the other side
It is important to note that with all exercises and stretches, pay attention to your body. Listen to the cues of what feels right, and do not force anything. If any exercises cause increased pain or discomfort, stop, and consult a medical professional.
Using Physical Therapy Exercises for Shoulder Pain Relief
In some cases, you can manage minor shoulder pain at home with a combination of exercise, stretching, and other natural remedies. For example, cold therapy using ice packs for 10-15 minutes intermittently, can sometimes help manage shoulder pain. In other cases, especially when the cause is muscular, warming the area helps. Heating pads or hot showers often provide a level of pain relief for sore shoulders.
There are some other things you can try for a painful shoulder. For instance, massage can loosen tight muscles, aid circulation, and reduce stiffness. Furthermore, adhering to a period of “active rest” can assist with shoulder pain. Keep the shoulder moving and flexible by doing pain-free exercises and stretches but avoid any activities that have the potential to stress the shoulder joint. Avoid heavy lifting, repetitive arm movements, and overhead activities while trying to cure a painful shoulder.
Managing Shoulder Pain
In summary, shoulder pain can occur at any stage of life for a variety of reasons. By trying simple at-home exercises and treatments you may be able to manage a painful shoulder on your own or perhaps avoid one altogether. If you are experiencing persistent pain, sharp pain, or if it is interfering with your ability to participate in normal daily activities, make an appointment with a trusted Physical Therapist for a thorough evaluation.