Shoulder symptoms include different types of pain including sharp, shooting, burning, throbbing or stabbing pains and can be constant or intermittent – i.e. come and go. As well as coming from a local injury, shoulder pain can also refer from your neck or back. If so you may also be getting pins and needles, tingling, weakness, numbness, other strange sensations or pain in one or both of your arms.

If the pain came on slowly and it is in the front or side of the shoulder then you could be experiencing shoulder impingement syndrome.

Shoulder Blade pain can be caused by issues in the upper back, neck, or shoulder itself. 

The Rotator Cuff is a group of deep muscles that help to control and stabilise the ball of the ball and socket shoulder joint, overuse of certain areas can cause imbalance that leads to pain. 

If you fell, had an accident or the pain came on suddenly then you may have torn a ligament, cartilage, disrupted the acromio-clavicular joint, damaged other structures like the labrum or even suffered a fracture.

Whatever it might you NEED to get the shoulder assessed by a Physiotherapist or Osteopath immediately. Even if you have not had a traumatic injury, it is essential that you get pain and other symptoms assessed by a Physiotherapist or Osteopath so that you do not do further damage.

How the Shoulder Works

The shoulder is formed of two joints: the glenohumeral joint which is the main ball and socket part, and the acromio-clavicular joint which is the small joint on the top of the shoulder between the collar bone, the clavicle, and the bit of the shoulder blade called the acromion. There is also the junction between the shoulder blade and the rib cage which is not strictly speaking a joint, but is fundamental to the function of the shoulder. The shoulder is a highly complex joint as it has to satisfy both complex and large movements, as well as providing stability for the movements and weight bearing activities of the elbow, wrist and hand.


The muscles supporting and moving the shoulder can be divided into the big external movement muscles which provide the “definition” of the shoulder like the deltoid and latissimus dorsi and the smaller, deeper stability muscles like the rotator cuff. Very commonly, shoulder problems develop from training which strengthens the external muscles but doesn’t address the stabilising muscles enough. Therefore, even in the presence of large external shoulder muscles, joint instability can occur. This results in small abnormal movements occurring within the joint during larger movements, causing damage to joint structures like the cartilage, muscles, tendons, bursa, ligaments and nerves. Unfortunately this type of pattern does not tend to get better on its own, and unless the smaller muscles are trained and movements re-retrained, the problem gets worse and worse. Hence, it is important to have proper assessment and treatment of any shoulder injury.

A huge number of shoulder problems we see are associated with the following things:

  1. The shoulder being in the incorrect position statically, i.e. poor posture, and also during movement i.e. poor movement patterns. This puts the shoulder muscles in a position that prevents them from working properly, resulting in excess strain going through the joint structures, even with normal everyday activities. Please click on the link to learn how to train your shoulder posture.
  2. Poor posture or movement in the spine – particularly the thoracic spine – your upper back – it is often too curved forwards and stiff, which prevents the shoulder from working properly. Please click on the link to learn how to release the thoracic spine.
  3. If the core muscles are weak they do not provide the solid foundation from which the shoulder can function efficiently resulting in excess strain put through the shoulder. Please click on the link to learn how to train your deep core muscles.
  4. Incorrect technique when doing day to day things like lifting, or sporting activities like swimming, tennis or weight lifting, resulting in excess stress and damage to the shoulder.

Treatment is focused not only on enhancing healing of the damaged tissue, but most importantly on addressing the underlying muscle imbalance and improving the posture and movement patterns of the shoulder and spine causing it. This will include hands on techniques to release the tight muscles and joints, and then exercises to retrain shoulder movements you do on a daily basis, as well as high level movements like smashing tennis balls, flying through the water or lifting heavy weights.

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    Common Injuries

  • Stiff Thoracic Spine

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  • Tennis Elbow

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  • Neck Pain/Tightness

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  • Cervical disc injury

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  • Shoulder Blade Pain

    Pain behind the shoulder, behind or around the shoulder blade and/or in your upper back/neck is not strictly speaking a shoulder problem because the pain is probably coming from the back or neck. However, lots of people refer to it as shoulder pain because thats where the discomfort is felt....

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  • Post-Operative Shoulder

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  • Sitting posture

    Sitting posture at work, at home or in the car is a major cause or cure of pain in the back, shoulders, neck, arms and knees. Please scroll down to the bottom for specific advice on how to adjust your posture in the car to avoid or reduce pain.  Sitting...

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  • Train rotator cuff muscles

    Please click here to read how the shoulder works before reading the following. It is important to strengthen the rotator cuff muscles in order to stabilise the shoulder joint. Do not do it if you have any pain. Your Physiotherapist or Osteopath will guide you to building up the weight...

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  • Release the thoracic spine

  • Release latissimus dorsi (lats)

    Please click here to read how the shoulder works before reading the following. The lats are often tight and over active relative to the smaller shoulder muscles like the rotator cuff muscles.    

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  • Stretching

      A note on static stretching v dynamic stretching I bet you can't remember the last time you saw elite athletes doing a static stretches pitch-, track- or court side pre-performance. That is because research now shows that static stretching is not advisable before exercise. This is because it slows...

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  • Train serratus anterior and shoulder stability

    Please click here to read how to train shoulder posture and click here to read how the shoulder works before reading the following. The serratus anterior muscle is commonly weak. An indication of this is if your shoulder blade looks like it is winging at the back.

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