The three most common types of shoulder pain – Part two


Is Your Desk or the Gym to Blame for your Shoulder Pain?

The shoulder is the most mobile joint in the body, which also makes it very vulnerable to injury and pain. Both sedentary and active populations are likely to experience shoulder pain at some point in their life, so whether you spend hours at your desk or at the gym (or both), here’s the second and third most common shoulder pain you need to look out for and how we can treat it.

Desk Related Shoulder Pain

The most common shoulder pain you’ll experience if you spend a lot of time at your desk isn’t even caused by an injury of the shoulder. An MRI or ultrasound wouldn’t show any issue, as the pain is likely coming from somewhere else: the nerves in your neck or upper back. If a nerve in your upper back or neck becomes irritated, pain will often spread out to your shoulders and even down your arm to your fingertips. Unless you have experienced direct trauma or disease, these nerves are usually irritated by poor posture in the spine.

Diagnosis involves positioning the spine into certain correct position to see if symptoms are relieved or even aggravated. If they are, it’s very likely that the pain is caused by an irritated nerve rather than the shoulder joint itself. Treatment consists of strengthening exercises of the upper back and neck to help reduce stress on your spine. We will also recommend lifestyle changes which introduce more movement, along with ergonomic adjustments to your workplace to help you improve your posture and reduce spinal load. Improvements will typically be felt as soon as the spine is put in a better position, and full rehabilitation is typically achieved in weeks rather than months.

Gym Related Shoulder Pain

Common amongst both novice gym-goers and veterans, weightlifter’s shoulder presents as inflammation at the very tip of the shoulder where the collarbone meets the shoulder blade, called the acromioclavicular joint (AC joint). Unlike the postural pain described above, the pain from weightlifter’s shoulder doesn’t spread beyond the site of the injury. Inflammation of the AC joint is usually caused by overloading of the shoulder during overhead presses, lateral raises or any other exercise which requires a full range of motion in the shoulder.

To reduce load on the shoulder, we need to strengthen the upper back, which is often neglected by gym-goers keen to pump up their beach muscles. Men in particular are often guilty of becoming chest obsessed to the detriment of their shoulders and upper back. This imbalance between tight pectoral muscles and comparatively weak upper back muscles pulls the body into a rounded shoulder posture, which overloads the shoulder whenever you attempt an overhead exercise.

You can easily observe the impact of a rounded shoulder on mobility yourself. Hunch your shoulders forward, then try and lift your arm up over your head, then try again with your shoulders pulled back. What you’ll find is that when you have rounded shoulders, you can’t lift your arms beyond 130-140 degrees, while you should be able to easily achieve a full range of motion when your shoulders are positioned correctly.

Rehabilitation takes many months of gradually increasing the strength and flexibility of the upper back while avoiding heavy overhead lifting which may further aggravate the AC joint. If you’re concerned about developing weightlifter’s shoulder, a rule of thumb that we recommend is to do two upper back exercises for every chest exercise to ensure that your upper body doesn’t become unbalanced.

While this blog will help you have a better understanding of the shoulder pain you might be at risk for, it is not enough to make a diagnosis. The shoulder is an incredibly complex structure, and only a professional diagnosis from a physiotherapist can tell you exactly what is causing it and how to make it better.

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david wynne physiotherapist knightsbridge

David Wynne BSc (Physio) MSc (Sports and Exercise Medicine) MCSP MHCP

Musculoskeletal and Sports Physiotherapist, Research Lead at West London Physiotherapy