Common Causes of Shoulder Pain and the Ways to Avoid Them

by Christina Lasich, MD Health Professional

Try washing your hair, brushing your teeth or getting dressed without the use of one shoulder, it's darn near impossible to do anything without your shoulders. We use our shoulders all day long, 365 days per year. And over the years, the shoulders may not be feeling as comfortable or limber as they once did back in your younger days. Or maybe you are in your younger years but have been hard on your shoulders. Whether you are young or old, stiff painful shoulders make life's daily activities much more difficult to get done.

The most common reason to have a painful shoulder is tendonitis. The shoulder is a complex joint with
a network of tendons called the rotator cuff
. As all of the muscles in the shoulder work to pull, push, lift and reach, the tendons - which attach the shoulder muscles to the bones - can get very inflamed and painful. Sometimes the rotator cuff actually gets pinched between two bones, the acromion and the humerus. This condition is called shoulder impingement. As the tendons rub between the bones, the chances of the tendonitis progressing to an actual rotator cuff tear increases. Once the tendons erupt in pain and inflammation, then the shoulder bursa is likely to become inflamed too. This is a condition called shoulder bursitis. All of this snowballs into a very painful shoulder that you can barely use, grinding your life to a halt.

Speaking of snowballs, the shoulder can also eventually become frozen. A frozen shoulder is literally frozen and will not move at all. Once you get to this point, you are looking at months of recovery, some injections and possibly even a surgery to repair a rotator cuff tear. Avoiding this avalanche of shoulder mayhem requires some preventative measures.

  • Maintain Good Shoulder Posture: The shoulders work best when aligned in perfect balance. Unfortunately in this day and age, we are doing too many tasks in front of our chest. The repetition of sustained postures caused by forward tasks eventually leads to the shoulder being misaligned into a forward position. The pectoralis muscle becomes tight and short. The rhomboid muscles become stretched and weakened. Soon, the humerus drifts forward and the shoulder blades spread apart. Prevention Tip: Stretch the pectoralis muscles throughout the day and add rowing to your daily workout in order to strengthen the rhomboids.

  • Limit Reaching: When you are reaching for items like the phone, coffee mugs, the stapler or a diaper bag, you are constantly stressing those shoulder tendons that tend to get inflamed and painful. Prevention Tip: If you place those frequently used items closer to within reach of your hands, then you will not have the reach out very far and grab them quite so often. By rearranging your work space or moving your feet, you will be helping your shoulders get through your day.

  • Strengthen the Shoulder: Most shoulder injuries occur to people who have lead very sedentary lifestyles and haven't maintained good shoulder strength. Women especially have weak shoulders compared to men; that's just the way we are built. Women are built differently than men and need to compensate for those differences by keeping muscles strong. One key muscle in the shoulders that is often forgotten but helps to prevent the rotator cuff from being pinched is the subscapularis muscle. Prevention Tip: A well balanced exercise program for the shoulder includes a strengthening all the rotator cuff muscles like the subscapularis in order to keep the humerus centered in a balanced position and to prevent it from drifting up (superiorly) or forward (anteriorly).

I hope this helps you to keep those shoulders moving smoothly without pain. All of these tips to prevent shoulder pain should be considered part of your daily maintenance program. You would not go a day without brushing your teeth, unless you have shoulder pain already, so don't go a day without keeping your whole body - not just your shoulders - in tip top shape.

Christina Lasich, MD
Meet Our Writer
Christina Lasich, MD

Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.