We see patients every day for shoulder pain issues.

Shoulder pain is experienced by individuals of all ages and can significantly impact daily activities and overall quality of life. We have encountered numerous patients with varying degrees of shoulder pain caused by a range of factors.

This blog post aims to inform and educate readers about the common causes of shoulder pain, the symptoms to watch out for, and how our team of therapists at Parkway can help you alleviate pain and treat shoulder related injuries.

Common Causes of Shoulder Pain

  1. Rotator Cuff Tears and Degeneration: The rotator cuff is a group of muscles and tendons that surround the shoulder joint, providing stability and enabling smooth movement. Overuse, aging, or sudden trauma can cause tears in these tendons, leading to pain and reduced mobility.
  2. Impingement: This occurs when the rotator cuff tendons become compressed and irritated by the surrounding bone structures, causing inflammation and pain during movement. This common cause of clinic visits can lead to pain in the acromioclavicular joint (AC Joint) and also to pain in the rotator cuff tendons.
  3. Referred Pain from the Neck: The muscles and tissues around the shoulder are mainly supplied by the C5 and C6 nerves from our neck. This is also the most frequent place of neck wear and tear and so we commonly see these two areas present at the same time.
  4. Hypermobility or Instability: This refers to a shoulder joint that is very mobile. At times this can occur in all directions but more commonly we see this occur in one direction – excess mobility in the front of the shoulder. These cases can also have many causes from genetic factors to posture and frequent use patterns such as throwing. Each case will stress tissues in the shoulder differently and each of these tissues are pain sensitive and can contribute to shoulder pain.

Symptoms to Watch Out For

  • Persistent pain in the shoulder area
  • Difficulty lifting the arm or performing overhead activities
  • Weakness in the shoulder and arm
  • Sharp pain during quick or unexpected movements
  • Stiffness and limited range of motion
  • Swelling, bruising, or tenderness around the shoulder joint
  • Pain at night and difficulty sleeping
  • Numbness or tingling anywhere in the arm or hand
  • Pain that goes down the arm or hand during shoulder or neck movements

Ignoring these symptoms can lead to chronic pain, loss of function, and tissue damage. It’s crucial to seek professional help as soon as possible to prevent further complications and longer rehabilitation time.

How Physiotherapy Can Help Shoulder Pain

Physiotherapists are experts in diagnosing and treating musculoskeletal issues, including shoulder pain. We will conduct a thorough assessment to determine the cause of your pain and develop a personalized treatment plan tailored to your specific needs. This may include:

  • Pain management techniques such as electrical stimulation or ultrasound
  • Manual therapy to improve joint mobility, improve joint nutrition and reduce inflammation
  • Strengthening and stretching exercises to restore function, rehabilitate damaged or degenerated tissues, prevent future injuries and return to activity
  • Trigger point release techniques to reduce pain and improve muscle blood flow and function
  • Dry needling techniques such as IMS (Intramuscular Stimulation)
  • Postural and ergonomic education to minimize strain during daily activities
shoulder pain treatment

At-Home Tips and Exercises to Reduce Shoulder Pain

While it’s essential to consult with a physiotherapist for a comprehensive treatment plan, here are some simple tips and exercises you can try at home to alleviate shoulder pain:

  1. Alternating Hot and Cold Therapy: Ice will typically reduce inflammation and heat will typically increase blood flow. Going back and forth between hot and cold will cause blood vessels to expand and constrict and this creates a pumping action that brings more oxygenated and nutrient rich blood to the healing tissues.

    Ending these sessions with cold will help ensure that shoulder inflammation is never exacerbated.  There are no precise rules when it comes to contrasting hot and cold so try the following to see if it helps relax your shoulder muscles and reduce pain. Apply a heat pack to the shoulder for 4-6 minutes and then apply an ice pack for 2-3 minutes for a total of about 30 minutes.
  1. Pendulum Exercise: Stand next to a table or counter for support. Lean forward slightly and let the affected arm hang down. Gently swing the arm in small circles, gradually increasing the range of motion as tolerated.

    These movement patterns increase shoulder joint lubrication and provide gentle manner of mobilizing the tissues. It is a passive movement which means that you should not be trying to muscle your shoulder back and forth but rather allowing it to swing very gently with an absolute minimum of force used.

    20 pendulums back and forth and 20 side to side plus 20 circles each clockwise and counter-clockwise can be repeated several times over the day.
  2. Shoulder Shrugs: These are pretty instinctive movements for many of us with shoulder pain. The movement is actually through the shoulder blade or scapula while the ball and socket of the shoulder move barely at all. Shrugs can stimulate muscle contractions followed by relaxation which can help shoulder pain to settle.

    If you add a bit of shoulder roll to your shrugs then that is fine as well. Most people spend too much time with their shoulders rolled forward so really emphasize the rolling back part where you open and expand the front of the chest.

    20 or so shrugs can be repeated several times per day.
  3. Neck Range of Motion: If your neck can relax then the shoulder can better relax. A tissue at rest can get blood flow while a tense or guarded tissue will have restricted blood flow. Also with respect to the referred pain and nerve supply to the shoulder mentioned above, neck range of motion can be an important part of many shoulder treatment programs.

    You can move slowly into one direction and then another and conversely you can hold a position for up to 60 seconds. If you have neck pain doing this then take it easy and give us a call. If you get shoulder or arm pain doing any of these then stop doing the neck movement and definitely call us for an assessment and treatment plan.

The Importance of Physiotherapy Assessment and Treatment for Shoulder Pain

Although these tips and exercises can provide temporary relief, it’s crucial to have a professional physiotherapist assess and treat your shoulder pain to ensure a speedy and effective recovery process.

We want to understand if your neck is contributing to your shoulder pain; whether there are muscle imbalances and regions of tightness or weakness that can be addressed; the grade of your injury and the stage of healing will determine the frequency, intensity, time and type of exercise used, and of course manual therapy and dry needling treatments to improve nerve function, improve tissue mobility, improve collagen alignment and reduce pain. 

Ultimately our team will co-create with you, a customized treatment plan, monitor your progress, communicate with other health professionals as required, and make adjustments as needed to optimize your recovery.


Shoulder pain can significantly impact your daily life, but with the help of a dedicated and well-trained team of physiotherapists, chiropractors, athletic therapists, kinesiologists and massage therapists, you can alleviate your shoulder pain, restore mobility, prevent future injuries and achieve your physical goals. 

If you’re experiencing shoulder pain, call us at one of the Parkway Physiotherapy and Performance Centres and start your journey towards a pain-free life.

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