Your Shoulder Hurts and You Don't Know Why. Let's Figure This Out.

Shoulder pain is weird. It can show up out of nowhere, stick around for months, and completely mess with your ability to do normal things. Reaching into the back seat of your car. Putting away groceries on a high shelf. Sleeping on your side without waking up at 3 AM.

And here's the frustrating part: most people have no idea what actually caused it. "I didn't do anything! It just started hurting one day."

So let's talk about what's really going on with your shoulder, why it's not getting better on its own, and what you can actually do about it.

Why Shoulder Pain Is So Complicated

Your shoulder is the most mobile joint in your body. That's great for function, you can reach in basically any direction, but it also makes it inherently unstable.

Think about it: your hip is a deep ball-and-socket joint. It's stable. Your shoulder? It's a shallow socket with a ball that barely sits in there. The only thing holding it together is a bunch of muscles, tendons, and ligaments working in perfect coordination.

When any part of that system gets out of whack, whether it's a weak rotator cuff, tight muscles, poor posture, or old scar tissue from a previous injury, the whole thing starts to compensate. And eventually, compensation leads to pain.

A lot of people think they just "slept wrong" or "overdid it at the gym," but the truth is, most shoulder pain builds up over time. That one thing that made it hurt? That was just the final straw.

What Actually Causes Most Shoulder Problems

In my experience, shoulder pain usually falls into a few categories:

Rotator cuff issues. These four little muscles stabilize your shoulder. When they're weak or injured, everything else has to pick up the slack. Result? Pain, weakness, and that feeling like your shoulder might give out.

Impingement. This is when tendons get pinched between bones every time you lift your arm. Over time, that pinching causes inflammation and damage. It's like closing a drawer on your finger repeatedly, it's going to hurt eventually.

Frozen shoulder (adhesive capsulitis). This one's brutal. Your shoulder capsule literally tightens up and restricts movement. Usually happens after an injury or period of immobilization. People wake up one day and can't lift their arm above shoulder height.

Referred pain from your neck. Plot twist: sometimes your shoulder pain isn't even coming from your shoulder. Nerve issues in your cervical spine can send pain down into your shoulder and arm. (I wrote about this in another post, it's more common than you think.)

General instability. Some people just have loose shoulders. Maybe from old injuries, maybe genetics. Either way, the muscles are constantly working overtime to keep everything in place, and that leads to fatigue and pain.

What NOT to Do When Your Shoulder Hurts

Before we get into what helps, let's talk about what makes things worse, because I see people doing these things all the time:

Don't just ignore it and hope it goes away. Shoulder problems rarely resolve on their own. They usually get worse as you compensate more and more.

Don't completely stop using your shoulder. I get it, movement hurts. But total immobility leads to stiffness and weakness. You need to find the sweet spot between protecting it and keeping it moving.

Don't only stretch. If your rotator cuff is weak, stretching alone won't fix it. You need strength. Flexibility without stability is just... loose instability.

Don't rely on pain meds as your only strategy. Ibuprofen might take the edge off, but it's not fixing the underlying problem. You're just masking symptoms.

Don't do a million random shoulder exercises you found on Instagram. Not all shoulder pain is the same. What works for impingement might make instability worse. You need the right exercises for your specific problem.

What Actually Helps: A Real Approach

Okay, so what should you do?

Get a proper evaluation. Seriously. You need someone who can figure out what's actually wrong. Is it weakness? Tightness? Impingement? Instability? Referred pain from your neck? You can't fix a problem you haven't correctly identified.

When someone comes to me with shoulder pain, I'm checking range of motion, strength, stability, posture, and how their neck and upper back are moving. The shoulder doesn't exist in isolation.

Start with pain-free movement. Early on, the goal isn't to push through pain. It's to find movements you can do without aggravating things, and build from there. Maybe you can't lift your arm overhead yet, but you can do some gentle pendulum swings or isometric holds. Start there.

Strengthen the rotator cuff and scapular stabilizers. Most people with shoulder pain have weak rotator cuffs and poor scapular control. We need to build that foundation back up. Exercises like:

• External rotation with a resistance band. Keeps your elbow at your side, rotate your hand away from your body. This strengthens the back of your rotator cuff.
• Scapular squeezes. Pull your shoulder blades together and down, like you're putting them in your back pockets. Hold for a few seconds. Repeat.
• Rows. Whether with a band or light weights, rows strengthen the muscles that stabilize your shoulder blade.

Improve your posture. If you're sitting hunched over a computer all day, your shoulders are going to be a mess. Rounded shoulders put everything in a bad position and make impingement more likely. Work on sitting up straight and pulling your shoulders back.

Manual therapy when needed. Sometimes you need hands-on work to release tight muscles, mobilize stiff joints, or break up scar tissue. This is where working with a PT makes a huge difference. I can feel what's restricted and manually address it in ways you can't do yourself.

Progress gradually. Once you've built some baseline strength and reduced pain, you can start loading the shoulder more. But we're talking weeks, not days. Shoulder rehab is a marathon, not a sprint.

Real Talk: How Long Does This Take?

People always want a timeline. "How long until my shoulder's better?"

Honestly? It depends.

Minor irritation or inflammation? Maybe a few weeks with the right approach.

Rotator cuff tendinopathy or impingement that's been going on for months? You're looking at 6-12 weeks of consistent work before you feel significantly better.

Frozen shoulder? That one can take 6-12 months. It sucks, but that's the reality. The capsule needs time to loosen up.

The key is consistency. Doing your exercises three times a week gets you way better results than doing them randomly when you remember.

When You Should Actually Worry

Most shoulder pain is annoying but not dangerous. However, you should get checked out right away if:

• You can't lift your arm at all after an injury
• You have severe, sharp pain that's getting worse
• Your shoulder looks deformed or out of place
• You're having numbness or tingling down your arm
• The pain is constant and not improving at all after a couple weeks

Those are signs something more serious might be going on, like a full rotator cuff tear, dislocation, or significant nerve issue.

Bottom Line

Shoulder pain doesn't have to be permanent. But it rarely fixes itself, especially if it's been going on for a while.

You need a proper evaluation, the right exercises for your specific problem, and someone who can guide you through the rehab process without making things worse.

Stop doing random stuff you found online and hoping for the best. Get help from someone who actually knows what they're doing.

Tired of your shoulder limiting what you can do?

Let's figure out what's actually wrong and fix it properly. I'm Dr. Rob Letizia, and shoulder problems are one of the things we treat most often.

Spectrum Therapeutic of NJ
601 Hamburg Turnpike, Suite 103
Wayne, NJ 07470

(973) 689-7123
spectrum@spectrumtherapynj.com
spectrumtherapynj.com

Call us. Let's get your shoulder working right again so you can stop babying it and get back to normal life.