If you have ever felt a painful twinge when you raise your arm or a sharp ache when you roll onto your shoulder at night, you have experienced shoulder pain. This type of pain can be incredibly disruptive to our quality of life because it can hamper our ability to accomplish even the simplest tasks, such as getting dressed and hanging up the washing.

At Healing Hands Osteopathy, we frequently treat patients with shoulder pain and are experienced in helping them understand their condition and find relief. In this blog, we will guide you through the same process by discussing the inner workings of the shoulder joint, common causes of shoulder pain, and effective shoulder pain management strategies.

Understanding the Shoulder Joint

The shoulder is one of the most complex areas of the body. It’s often mistaken for just being the ball and socket (Glenohumeral) joint, like the one you might see footy players dislocate. In reality, the shoulder girdle is a combination of several joints working together. These include the:

  • Glenohumeral (GH) Joint: The ball and socket joint most people think of.
  • Acromioclavicular (AC) Joint: The joint between the shoulder blade (scapula) and collar bone (clavicle).
  • Sternoclavicular (SC) Joint: The joint between the collar bone and breast bones (sternum).
  • Scapulothoracic Joint: The functional joint where the shoulder blade moves on the rib cage.

Key Muscles of the Shoulder Girdle

The main muscles supporting the shoulder girdle are the Rotator Cuff muscles. These four small muscles (Infraspinatus, Supraspinatus, Teres Minor, and Subscapularis) connect the shoulder blade to the upper arm and stabilise the GH joint.

Other important muscles include the Latissimus Dorsi (Lats), Pectorals (Pecs), Rhomboids, Trapezius (Traps), Biceps, Deltoids, and Triceps.

The Role of the Subacromial Bursa

Another important structure in the shoulder complex is the Subacromial Bursa. A bursa is a fluid-filled sac that sits between bones and tendons or between tendons and ligaments to provide cushioning. This cushioning allows for the smooth gliding of tendons and ligaments, preventing friction between and fraying of the fibres within these structures.

Shoulder Pain and Subacromial Impingement

One of the most common causes of shoulder pain is called Subacromial Impingement. This most often presents as pain that occurs through the tip of the shoulder and which can radiate down into the upper arm. But what causes this and how can it be treated?

The Subacromial Space is essentially a tunnel between the top of the GH joint and the Acromion process of the shoulder blade. Many tendons of the shoulder muscles travel through this space, and it is also where the Subacromial Bursa sits. The nerves and blood vessels that supply the arm also pass through this space.

When you raise your arm above your head, this space can become smaller, compressing the structures that travel through it. Poor posture, such as rounded shoulders, can further reduce this space. If the tendons of the Rotator Cuff or other shoulder muscles become impinged (or squashed), it can lead to inflammation of the tendons, known as Tendonitis. Similarly, if the bursa is affected and becomes inflamed, it is referred to as Bursitis.

Symptoms of Subacromial Impingement:

  • Difficulty with above-head arm movements.
  • Shoulder pain when lifting arm.
  • Pain when reaching behind the back (e.g., doing up a bra).
  • Weakness in shoulder muscles if tendons are affected.
  • Pain while lying on the affected shoulder.
  • Numbness, tingling, or shooting pain in the arm if nerves are impinged.

Managing Shoulder Pain

The first step in shoulder pain management is to reduce inflammation. Anti-inflammatories can be taken orally (such as Nurofen or Voltaren) or applied topically to the region (like Fisiocream or Voltaren gel). Once the inflammation is minimised, it’s essential to avoid aggravating activities, such as overhead movements or reaching behind your back.

Stretching and Exercises

Stretching the shoulder muscles can help loosen the area, but staying within a pain-free range is crucial. Stretching should never be painful. Here are some stretches and exercises that might help with shoulder pain:

Pectoral Stretch

This stretch targets the chest muscles, helping to open up the front of the shoulder.

  1. Stand in a doorway with the arm of the side you are stretching leaning against the doorframe at a 90-degree angle.
  2. Step the foot on the same side forward slowly until you feel a gentle stretch across your chest.
  3. Hold the stretch for 20-30 seconds, keeping your shoulders down and back.
  4. Return to the starting position and repeat 2-3 times daily, switching sides as necessary.


This gentle exercise helps to mobilise the shoulder without straining it.

  1. Stand next to a table or chair and lean forward. Make sure the furniture is on your non-affected side. Press the palm of your non-affected arm down onto the furniture to support yourself and keep your back straight.
  2. Let your affected arm hang down freely.
  3. Begin gently swinging the free arm in small circles, gradually increasing the circle’s diameter.
  4. Perform this motion for 1-2 minutes in each direction (clockwise and counterclockwise).

Scapular Squeezes

Strengthening the muscles that stabilise the shoulder blade can improve overall shoulder function.

  1. Sit or stand with your back straight and shoulders relaxed.
  2. Bend your elbows 90 degrees and have your palms facing upwards.
  3. Squeeze your shoulder blades together as if you are trying to pinch a pencil between them.
  4. Hold the squeeze for 5-10 seconds, ensuring not to shrug your shoulders.
  5. Release and repeat 10-15 times, twice daily.


*Disclaimer: These tips are for general shoulder pain management information only and may not be relevant to your situation. If you are unsure whether these exercises are suitable, if your pain is not subsiding, or if these exercises exacerbate your shoulder pain, it’s essential to get assessed by a health professional or make an appointment with your GP.

Seeking Professional Help

If your shoulder pain persists, professional help can make a significant difference. At Healing Hands Osteopathy, our osteopaths and remedial massage therapists are experienced in treating shoulder pain.

We provide a thorough history and physical assessment to understand the root cause of your pain and offer specific treatments and advice tailored to your condition. Book your appointment at our shoulder pain clinic in Croydon today to start your journey towards a pain-free shoulder.