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Shoulder Pain

Dr. Michael Hoiles has created this resource to help you better understand Shoulder Pain, including its common causes, symptoms, treatment options, recovery expectations, and when it may be appropriate to seek an assessment. Whether your symptoms started suddenly or developed gradually over time, this guide is designed to provide clear, evidence-informed information to help you make informed decisions and return to the activities you enjoy with confidence.

 

What Is Shoulder Pain

Shoulder Pain refers to discomfort or dysfunction in the shoulder joint and surrounding structures, including muscles, tendons, ligaments, bursae, and joint surfaces. It commonly results from irritation, overload, or restricted movement within the shoulder complex. 

The shoulder is highly mobile but less stable than other joints, making it more prone to overuse and mechanical irritation. 

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Common Causes 

  • Rotator cuff strain or tendinopathy  

  • Shoulder impingement syndrome  

  • Bursitis (subacromial irritation)  

  • Poor posture (rounded shoulders, forward head position)  

  • Frozen shoulder (adhesive capsulitis)  

  • AC joint irritation or sprain  

  • Overuse from repetitive overhead activity or lifting  

  • Sudden strain or minor trauma  

 

Often, shoulder pain develops gradually due to a combination of factors rather than a single injury. 

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Common Symptoms 

  • Pain when lifting or reaching overhead  

  • Discomfort when reaching behind the back (e.g., dressing, fastening seatbelt)  

  • Shoulder stiffness and reduced range of motion  

  • Pain lying on the affected side  

  • Aching in the front, side, or top of the shoulder  

  • Weakness with pushing, pulling, or lifting movements  

 

Symptoms can vary depending on the tissues involved and the severity of the condition. 

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What Makes It Worse? 

  • Repetitive overhead movements  

  • Poor posture (rounded shoulders, prolonged desk work)  

  • Sleeping on the affected side  

  • Sudden or heavy lifting  

  • Prolonged inactivity or immobilization  

  • Reaching behind the body under load  

 

Many people notice symptoms are worse after long periods of sitting or inactivity or after periods of repetitive movement or overuse. 

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What Helps? 

Many people find relief through: 

  • Relative rest (avoid aggravating movements, not full rest)  

  • Gentle mobility exercises to maintain range of motion  

  • Postural correction (especially during desk work)  

  • Gradual strengthening of shoulder and upper back muscles  

  • Heat (for stiffness) or ice (for acute irritation)  

  • Breaking up long periods of sitting or inactivity  

 

Staying active and addressing contributing factors often leads to better long-term outcomes than relying solely on passive treatments.

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How Chiropractic Can Help 

Chiropractic care may support shoulder pain recovery by: 

  • Assessing whether pain is coming from the shoulder joint, neck, or upper back  

  • Improving mobility in the shoulder, thoracic spine, and cervical spine  

  • Reducing joint restriction and muscular tension contributing to pain  

  • Providing soft tissue therapy to surrounding muscles  

  • Guiding progressive strengthening and movement retraining  

  • Addressing posture and movement habits that contribute to overload  

Shoulder pain is often multifactorial, so treatment typically focuses on both local shoulder mechanics and related spinal function. 

 

When Is Shockwave Therapy Recommended for Shoulder Pain? 

For some shoulder conditions, Shockwave Therapy may be recommended as part of a comprehensive treatment plan, particularly for persistent tendon-related pain that has not responded fully to exercise and other conservative treatments. 

Shockwave therapy is most commonly used for conditions such as rotator cuff tendinopathy and calcific tendinopathy, where it may help stimulate the body's natural healing response and reduce pain. 

Treatment delivers acoustic pressure waves to the affected tissue. These pressure waves are thought to improve blood flow, promote tissue repair, and reduce pain sensitivity within the injured tendon. 

Research suggests that shockwave therapy can be an effective option for many chronic shoulder tendon conditions, particularly when combined with progressive strengthening exercises, manual therapy, mobility work, and activity modification. 

During your assessment, we'll determine whether your shoulder pain is likely to benefit from shockwave therapy and whether it should be included as part of your individualized treatment plan. 

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Recovery Timeline 

Every case is unique, but general recovery timelines may include: 

  • Mild strain or irritation: 1–3 weeks  

  • Moderate tendinopathy or impingement: 3–8 weeks  

  • Frozen shoulder or chronic cases: 3–12+ months  

Recovery depends heavily on the underlying cause, activity modification, and consistency with rehab exercises. 

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Exercises Commonly Recommended 

Phase 1: Calm Pain & Restore Gentle Movement

Goal: Reduce pain, maintain mobility, and prevent stiffness.

  • Pendulum (Codman's) exercises – Gentle swinging movements to reduce joint stiffness.

  • Assisted shoulder flexion (using a stick or opposite arm) – Restore comfortable overhead movement.

  • Table slides or wall slides – Improve shoulder mobility with minimal strain.

  • Scapular setting exercises – Gently activate the shoulder blade muscles.

  • Isometric shoulder exercises (pain-free) – Light muscle contractions without moving the joint.

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Phase 2: Restore Strength & Shoulder Control

Goal: Improve strength, stability, and movement quality.

  • Resistance band rows

  • External rotation with a resistance band

  • Internal rotation with a resistance band

  • Scaption raises (thumb up, light weight)

  • Serratus punches (supine or standing)

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Phase 3: Return to Normal Activity & Prevent Recurrence

Goal: Build endurance, overhead strength, and confidence for work, sport, and daily activities.

  • Standing shoulder press (light dumbbells as tolerated)

  • Farmer carries

  • Push-up progression (wall → incline → floor)

  • Face pulls

  • Single-arm overhead carry or kettlebell carry

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Can I Still Exercise? 

Yes — in most cases, exercise should be modified rather than stopped completely. 

Recommended: 

  • Lower body training (as tolerated)  

  • Pain-free upper body movements  

  • Light resistance band work  

  • Controlled mobility and stability exercises  

  • Walking or cardio that does not aggravate symptoms  

Avoid early on: 

  • Heavy overhead pressing  

  • Painful ranges of motion  

  • High-load pushing or pulling movements  

  • Sudden ballistic shoulder movements  

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When To Seek An Assessment 

Consider booking an assessment if: 

  • Pain lasting more than 1–2 weeks without improvement  

  • Difficulty lifting the arm or performing daily tasks  

  • Recurrent shoulder pain with activity  

  • Noticeable weakness or loss of range of motion  

  • Pain interfering with sleep or work function  

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When Should I worry?  

Seek urgent medical assessment if you experience: 

  • Sudden inability to move the shoulder after trauma  

  • Visible deformity (possible dislocation or fracture)  

  • Severe, unrelenting pain following injury  

  • Significant swelling, redness, or fever (possible infection)  

  • Sudden neurological symptoms in the arm  

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Summary 

✔ Shoulder pain is usually related to rotator cuff irritation, impingement, joint dysfunction, or postural overload 
✔ Symptoms include pain with reaching, lifting, overhead activity, and lying on the affected side 
✔ Most cases are mechanical and improve with movement-based rehab, not prolonged rest 
✔ Common aggravators include overhead activity, poor posture, and repetitive strain 
✔ Chiropractic care may help by improving joint mobility, posture, and guiding progressive rehabilitation 
✔ Red flags such as trauma, deformity, or severe loss of function require urgent assessment 

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Ready to Get Back to Moving Comfortably?

If your shoulder pain isn't improving, keeps returning, or is preventing you from working, driving, exercising, or enjoying your daily activities, an assessment can help identify the underlying cause and determine the most appropriate treatment plan. 

Dr. Michael Hoiles is a Calgary chiropractor who provides evidence-informed care combining hands-on treatment, exercise-based rehabilitation, and practical advice to help people recover from injury, move better, and stay active. 

Book an appointment with Dr. Michael Hoiles today to start your recovery and get back to doing what you enjoy. 

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