The Bespoken Word

Rx: Shoulder Pain


Rx: Shoulder Pain



There are many different types of shoulder pain, some of which are more serious than others. From impingement and tendinopathies to rotator cuff sprains and tears, symptoms can be diverse and distributed throughout your shoulder, neck and arms. This area has so much range of movement that it is one of the most complex regions in the body and if you’re having pain it’s always best to get it checked out by an expert.

Today though, we’re going to look at one of the most common types of shoulder pain – impingement – and some simple tips to address this problem if you’re catching it early.

Shoulder impingement (also sometimes referred to as thrower’s shoulder or swimmer’s shoulder) may cause pain in the front of the shoulder or on the top of the shoulder. This injury may result from muscle imbalances, inflammation and/or poor mechanics.

[Mechanism of Injury + Affected Tissues]

Impingement usually feels like a pinch in the shoulder when you lift up and overhead (pain is usually in the superior (top), side, or anterior (front part) of the shoulder). Over time it can lead to more serious issues. It usually stems from poor mobility and stability of the scapula, which can be caused by trauma or adaptive behaviors. If you have poor scapular control or weakness of the scapular, you may compensate by using the upper trapezius more than normal. When this occurs, you will elevate the shoulder blade as it rotates out, hence closing the subacromial space and causing an impingement (rotator cuff tendon, supraspinatus, becoming impinged as it passes through the subacrominal space)

It may also occur when muscle imbalance is present, which may be felt with overhead lifting tasks. This may be a result of poorly sustained posture, (i.e.- sitting at a desk all day), an overworked muscle group, such as a repetitive overhead motion (i.e. – swimming or throwing), or during sleeping if your arm crosses your chest.

Medical care should be sought immediately during the acute phases of this injury in order to control pain & inflammation in the shoulder, if untreated it may eventually lead to a more serious injury.


Physical Therapy should focus on:

Modulating the pain

Normalizing shoulder and thoracic spine range of motion

Mobilizing the soft tissue surrounding the joint (shoulder, scapular, thoracic spine, & postural musculature)

Postural alignment changes made by your Physical Therapist

Strengthening the muscles surrounding the joint (shoulder, scapular, thoracic spine, & postural musculature)

Making the proper exercise and ADL modifications to promote pain free activities & movements


[Healing Timeline]

The American Academy of Orthopedic Surgeons, stats that in most cases, the treatment is nonsurgical (there can be times when the impingement is being caused by an anatomical defect and may require surgery – the only way to figure this out may be through imaging). They also state that nonsurgical treatment may take several weeks to months and many patients experience a gradual improvement as they return to function. This is not the case for everyone. With some cases, the improvement may be right away, but with this type of injury you must be compliant with the program and modifications in order to  create an ideal healing environment. The goal of treating this injury is to create a more durable shoulder complex (shoulder & shoulder blade musculature) in order to become stronger and to avoid re-injury.

Other forms of treatment that your MD may subscribe may include NSAIDs or non-steroidal anti-inflammatory medicines and steroid injections, such as local anesthetic and a cortisone preparation.



In 2006, approximately 7.5 million people went to the doctor’s office for a shoulder problem, including shoulder and upper arm sprains and strains. More than 4.1 million of these visits were for rotator cuff problems.

A study in 2018 state that  up to 50% of the National Collegiate Athletic Association (NCAA) football players have a history of shoulder injuries.


Check out our Instagram post for a short Shoulder Pain rehab guide – @BespokeTreatments Rx: Shoulder Pain

*This does not constitute medical advice. If you have pain or injury please consult a medical profession in person