07922 884 788

Shoulder

Shoulder pain

Pain reaching overhead or behind you, a shoulder that will not move freely, or pain that wakes you when you roll onto it.

What it typically feels like

  • Pain lifting the arm overhead or out to the side
  • A catch or pinch at a particular point in the range
  • Pain at night, especially lying on that side
  • Struggling to reach behind your back

The shoulder trades stability for range — it moves further than any other joint in the body, and it relies on muscle rather than bone to keep it stable. That is why it is both so useful and so easily upset.

What usually causes it

  • Overhead work or sport — throwing, swimming, pressing, painting a ceiling. Repeated overhead load with insufficient control.
  • Desk posture, which rounds the shoulders forward and narrows the space the tendons run through, so they get pinched on the way up.
  • A stiff upper back. If the thoracic spine does not extend, the shoulder has to make up the difference and gets overworked.
  • Sleeping on it night after night, which is often what turns a niggle into something that wakes you.

The neck connection

A great many “shoulder” problems are not in the shoulder. The upper trapezius and the muscles at the base of the neck refer pain straight into the shoulder and down the arm, which is why treating the sore spot often changes nothing. Assessment sorts out which one it is before anything is treated.

What treatment involves

Restoring the movement first — soft tissue work through the rotator cuff and the muscles around the shoulder blade, joint mobilisation if the joint itself has stiffened, and work on the upper back if that is limiting things.

Then strengthening. A shoulder that hurts is usually a shoulder that lacks control, and hands-on treatment alone will not hold without it.

What is actually in the shoulder

The most mobile joint in the body, and mobile for a specific reason: the socket is shallow, roughly the size of a golf tee holding a golf ball. Almost all of its stability is muscular, which is why the muscles matter so much here.

Glenohumeral joint
The ball and socket itself. A large humeral head sitting on a small, shallow glenoid — enormous range, very little bony stability.
Rotator cuff
Four muscles — supraspinatus, infraspinatus, teres minor and subscapularis — whose job is to hold the ball centred in the socket while the big movers do the lifting. Supraspinatus is the one most often irritated.
Subacromial space
The narrow gap between the top of the arm bone and the bony roof above it, with a tendon and a bursa running through it. Reduce that space and the contents get compressed — the pinch felt midway through lifting the arm.
Scapulothoracic movement
The shoulder blade must glide and rotate on the rib cage for the arm to get overhead. If it does not, the joint runs out of room early and the cuff takes the impact.
Acromioclavicular joint
The small joint on top of the shoulder where the collarbone meets the shoulder blade. Distinctive because pain sits precisely on the point of the shoulder rather than deep inside it.

Why it goes wrong

The painful-arc pattern — comfortable at the bottom, sore in the middle, easier again at the top — is the signature of something being compressed in that narrow subacromial space. Most of the time the underlying cause is not the tendon itself but the shoulder blade failing to move properly beneath it, which is why treatment that only chases the sore spot tends to disappoint.

3D anatomy See the structures involved on the interactive model

The honest next step

This page describes what is common, not what you have. The only way to know is to have it assessed — and your first session includes a full assessment, so you leave knowing what is actually going on.

Book an assessment Call 07922 884 788