02 Feb Shoulder Pain and Tightness
One of the more common conditions that we see clinically and in the gym relate to the shoulder.
This applies to our throwing athletes, fitness enthusiasts and office workers alike, all of which
have common themes in their presentation, treatment and rehabilitation. The first step to helping
these clients are to help them understand what might be going on with their shoulder, teaching
them the optimal positioning and movements, and then coaching them through rehabilitation
and training exercises. Here is a simplified overview of the most common shoulder presentation.
Shoulder Pain and Shoulder Tightness
Do you get headaches? Do you get neck pain at the end of the day? Does you shoulder click
and pop when you do certain movements? Does your posture look like you’re slumped forwards
and rounded through your shoulders?
All these are very common issues that people have which all relate to the shoulder. A key
similarity between all of these presentations are that they could be traced to your shoulders in
some way, and some straight forward changes in habit, recovery and rehabilitation methods and
strengthening exercises can all help resolve these issues* 1 .
Good Shoulder Habits
Everything in the body is connected – some things more than others – but a key principle is that
if something is happening to one thing, it will inevitably affect something else in the body. In the
case of the shoulder, a really common relationship is between the spine, the shoulder blade
(scapular) and the shoulder (humeral head) – when referring to the ‘shoulder’ we are referring to
the glenohumeral joint, which is the humerus attaching to the scapular. Whatever happens to
the scapular, the humeral head will have to follow – therefore a common habit we encourage is
to stabilize the scapular to create a solid foundation for the humerus.
We will therefore use the cue: ‘Shoulder blades back and down’ , which will encourage retraction
and depression, to counteract the common presentation of being protracted and elevated.
Creating this stable base will reduce the chance of pain and tightness, giving more balance to
Image Credit: acefitness.org
In addition, an anteriorly translated humerus is also a common element to people who see us
with neck and shoulder pain. We use the cue: ‘ Make your shoulders wide’ and ‘Externally rotate
at the shoulder ’ – this will position the shoulder in a more stable position, and encourage the
rotator cuff to evenly stabilize the joint. Another way of putting it is to imagine your shoulder as a
corkscrew and to ‘screw’ the humeral head back in to the joint.
Basics for everyday maintenance
As well as these cues to create a stable base and good positioning, there are other exercises to
help strengthen and build the stability and tolerance of the shoulder tissues. As a general rule,
the majority of people are anterior dominant in the strength and resting position of their muscles,
particularly at the shoulder. Therefore any exercises that focus on counteracting this are
excellent at reducing pain, discomfort and tightness.
Some of these exercises would be:
– Rowing exercises
This could be a barbell row, dumbbell row or cable/band row – the key principle
here when thinking about your shoulder is to create that stable base with your
shoulder blades, and generate tension at the humeral head by screwing it in to
– Kneeling Band or Cable External Rotation in Scaption
Kneeling on one knee, holding a band or cable. Position your arm up to your side
and then forward 45 degrees (this position is called shoulder scaption). Bend
your elbow and perform shoulder external rotation from this position. Again key
focus is to ensure a solid scapular base, and humeral head position.
– Banded or Cable row to external rotation
Standing in front of a cable or band, can either be single arm or double arm. Row
the cable or band with your elbows up, until your elbows are in line with your
shoulders. Ensuring a stable base (scapular and humeral head), externally rotate
keeping your elbow as the pivot point.
These exercises and movements are a general guide for a couple of common shoulder
conditions, however if you want more specific exercises or treatment then don’t hesitate to come
book a session with us where we can assess and provide you with even more knowledge and
help to get you pain free and performing at your best.
* 1 This is a general statement and no guarantee that the information provided and techniques
described here will apply to your shoulder condition – This information is intended for general
* 2 If the pain is being caused by damage to tissue or there are further pathologies present, then
further assessment and treatment is required.
– By Ollie Rix (MSc, PGCHE, BSc, CMT)