Having shoulder pain sucks.
Not knowing why its happening really sucks.
And pushing through painful workouts with hopes that it will magically improve sucks worse than a two dollar vacuum.
Well suck no more, my friend! Let’s talk about 10 potential reasons why your shoulder feels like it hates you.
You drive a car right? You know how (hopefully) you have to rotate and replace your tires after a while because the tread wears down? Well, your body is no different. If you continually perform certain movement patterns over and over without ‘rotating the tires’ aka movements, exercises, or intensities, your body will wear down just like the tread on your tires.
And really this goes for the whole body. This is why you tend to see long distance runners with so many nagging issues in their lower extremities. They’re routinely taking tens of thousands of steps (reps) on a daily basis so it’s really not a shocker when they develop stress fractures, plantar fasciitis, painful this, hurt that, etc.
So if you’re barbell benching on Monday, Wednesday, Friday for 12 straight weeks without changing it up, theres a solid chance you’re gonna have some overuse issues going on with the muscles at your shoulder and shoulder girdle. Same thing applies to those participating in sports. Constantly throwing, swimming, or repeatedly reaching overhead is really no different than benching 24/7.
#2 Your Rotator Cuff Is Weak
Early in my training career, it was my go to assumption that if you had shoulder issues, blame the rotator cuff.
Need to warmup for upper body day? Hit some external rotations for the cuff.
Rehabbing? Work the cuff.
You lost the spark in your current relationship? Probably has to do with your weak cuff.
I now realize there’s a LOT more contributing to optimal shoulder health, but the rotator cuff is still pretty important to a healthy shoulder.
Your right shoulder viewed from the side
Textbooks will tell you the job of the rotator cuff is to externally and internally rotate the shoulder, but we’ve come to learn its REAL purpose is to stabilize and keep the head of the humerus (upper arm bone) centered nicely within the glenoid fossa of the scapula (the ‘socket’ part of your shoulder blade). A weak rotator cuff will basically have your shoulder acting like a single jelly bean inside of a jar. That jelly bean (the head of your humerus) will rattle around in the jar (glenoid fossa) causing issues and problems when it comes to movement mechanics of the shoulder.
Strengthen the rotator cuff and suddenly you’ve got hundreds of jellybeans. No more rattling!
#3 You Have Limited Controlled Scapular Mobility
Quality shoulder health isn’t just limited to the shoulder joint itself. The mobility (or lack of) from your shoulder blade plays an incredibly huge role in determining if your shoulders are pain free.
Your scapula can elevate (move up), depress (move down), retract (pinch together towards spine), protract (“un-pinch” and move away from spine), tilt backwards, tilt forwards, upwardly rotate, and downwardly rotate. All of these movements and the combination of them contribute to proper functioning of the shoulder. When the shoulder blade doesn’t move well, you’re probably gonna run into some issues.
However, having scapular mobility isn’t enough. Notice #3 says controlled mobility, meaning we don’t want it moving around all willy nilly and loosey goosey. If the muscles responsible for keeping the shoulder blade stable don’t work, it can potentially rest in a bad position along the ribcage which will affect how your humerus interacts with it. If you’ve ever heard the term scapula winging (kinda like this dude), this is what we’re talking about.
#4 You’ve Got Poor Glenohumeral Range Of Motion
It’s possible that your scapula moves well, buuuut you still might be limited in your range of motion, specifically at the glenohumeral joint (shoulder joint).
Injuries (labral tears, fractures, muscle strains, bursitis, etc) can result in limitations in range of motion at your shoulder, as well as bony overgrowths that don’t allow bones to move like they should.
And even if you are healthy and haven’t had injuries, you can still have poor range of motion at the shoulder joint, probably because of the next point, which is…
#5 You’ve Got Soft Tissue Restrictions
This basically means you’ve got knots, tigger points, or unwanted tension going on at the muscles surrounding your shoulder and shoulder girdle. It’s pretty hard to have quality mobility when muscles are constantly tight or knotted up.
Some of the usual suspects for increased tone resulting in shoulder issues are the lats, pec minor, teres major, and levator scapula… all of which have attachment points on or around the shoulder.
Tight lats = you’ll struggle to lift your arms overhead without arching your low back.
Tight pec minor = scapula gets stuck in a forward tilted or downwardly rotated position (your scapula needs to tilt backward and rotate upward to have good range of motion).
And same thing for those other guys mentioned as well.
Unwanted tension can be the result of what you do for a living, sports you play, injuries you’ve sustained, etc. It can also be your body laying down some protective tension because you move like crap or you’re severely lacking in the strength department (you’ll find moving like crap and being weak tend to go hand in hand).
But good news, some consistent use with a foam roller and/or lacrosse balls and you can help improve this problem! High five! Now a low five!
#6 You Have Poor T-Spine Mobility
Ok, right now sit/stand up nice and tall…think very good posture. While maintaining this posture, lift your arms above your head. Pretty smooth and easy right?
Great. Now hunch forward and round your spine. Think hunchback. Try and do the same thing. Not so easy and smooth anymore is it?
I’d bet a brand new pack of Big League Chew that your range of motion was severely limited when you were hunched over. And the reason for that is quite simple.
Your thoracic spine has a very intimate relationship with your ribcage in a sense that it basically determines how the ribcage is positioned.
Your scapula also has a nice relationship with the ribcage in the sense that your scapula rests on the ribcage, kinda like how two spoons can stack on one another. A nice concave/convex relationship.
So it goes to reason that if your thoracic spine can’t move well, or is stuck in flexion (ex: desk workers), your ribcage might sit in a funny position, which will affect how the scapula sits on the ribcage, which will affect the scapula’s ability to move, which will affect how the humerus interacts with the scapula, which will affect your shoulder health. It’s just one painful domino effect.
Perhaps a couple thoracic extension and rotation drills are just what you need to make your shoulder feel better?
#7 Your Current Program Sucks
This point is pretty similar to #1: overuse, but having a lopsided program in terms of pushing exercises to pulling exercises can be a huge reason why shoulders start to feel cranky.
A pushing exercise would be classified as a bench press or shoulder press, while pulling exercises would be your rows and chinups. Unfortunately in today’s modern world of narcissistic, selfie taking, mirror loving gym goers, the muscles on the front side of your body tend to take priority over the ones on the back.
These are also the muscles that when overworked can cause shoulder issues.
A good rule of thumb is for every press you do in a given program, perform an equal number of pulls.
To be extra cautious, always perform more pulls than you do pushes. Some folks really benefit from a 2:1, or even a 3:1 pull to push ratio in their programs.
#8 You Breathe Wrong. Seriously.
The quality of each breath you take can, in fact, have an impact on how well you move.
A lot of people nowadays just don’t know how to breathe well, and by breathe well I mean quality diaphragmatic breaths. The diaphragm is pretty important when it comes to respiration (breathing) and when you don’t use it like you should, other problems can develop.
When you lose the inability to breathe diaphragmatically, this forces secondary breathing muscles, like the ones around your neck, shoulders, and chest to kick in and start working when they shouldn’t be. These secondary muscles are only supposed to start working when you’re out of breath, like after a sprint.
This breathing pattern also signals the ‘fight or flight’ response in your body which will only cause muscles to increase tone and be tight when they shouldn’t be.
PLUS, you take 10,000 breaths per day. If your accessory respiratory muscles at the neck, shoulders, and chest are performing 10,000 reps (breaths) per day, they’re gonna develop overuse issues, knots, and trigger points. This leads to less mobility and you hating life.
#9 You’ve Got Poor Technique
You lift like a jackass. Hire a coach.
Or at the bare minimum record yourself and pinpoint where you can improve.
#10 You Have A Type 3 Acromion
A type 3 acromi-whats-it?
Your right shoulder, viewed from the front.
Your acromion is a part of the scapula that connects to the clavicle (collar bone).
The acromion can be classified in 3 ways: Type 1, Type 2, or Type 3.
Also your right shoulder (scapula), viewed from the side
As you can see, if you’ve got a type 3 acromion, you kinda drew the short straw when it comes to risk factors contributing to shoulder health. Your bone structure just don’t leave a ton of room for tendons and bursa (fluid filled sacs that help decrease friction between bones) to run through, which makes impingement more likely during movements involving your shoulder.
So the only way to prevent this is to build a time machine and stop your parents from bumpin’ uglies. But then you run the risk of never existing.
So sorry amigo, but you’ve gotta play the hand you were dealt.
OMG A BONUS REASON! IT’S NOT EVEN MY BIRTHDAY!
You may not believe me, but if your shoulder hurts, check your opposite ankle for mobility restrictions. The tissues in your body are connected in all sorts of ways, one of them being a spiral fashion from the lower extremity to the opposite side on your upper body. Isn’t the human body so much fun?!?!
Anatomy Trains, Thomas Myers
SUPER MEGA BONUS #12
OOOOOOOH MMYYYYY GAAAWDD WHAT IS HAPPPPENING?!? ANOTHER ONE?!
Lastly, another reason you’ve got shoulder issues is because your cervical spine (neck) isn’t functioning like it should be.
However, if someone came to me with neck issues, I would promptly escort them to a qualified physical therapist.
So I’m not even gonna bother writing about this. Go see someone who knows what they’re doing if your neck hurts.