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Jordan Loewenstein, D.C. | La Jolla Chiropractor

Exercise & Stretch Library

Shoulder Pain
By Location

Pick the part of your shoulder that hurts. You’ll get the conditions that actually live there, the clues that tell them apart, and the specific stretches and exercises for each one.

Five Locations Mapped
A Program For Each Diagnosis
UTC San Diego — Near UCSD
Night Pain Matters
It separates the big problems from the small
Most Cuffs Respond
8 to 12 weeks of loading, not rest
Check the Neck
Plenty of shoulder pain starts above it
Know the Red Flags
Chest pressure is a 911 call
Start Here

Where Does It
Actually Hurt?

Shoulder pain sorts out faster than most people expect. Pain on the outer arm that catches halfway up is a different problem from a pinpoint sore bump on top, and both are different from a deep ache that wakes you at 3am. Pick your spot below, read the clues, then open the program that matches.

Two questions do most of the work here. Can you sleep on that side? and can someone else move the arm further than you can? Night pain points toward the rotator cuff or a frozen shoulder. Motion that is limited even when the arm is relaxed and someone else is moving it points strongly at a frozen shoulder rather than a tendon problem. Keep both in mind as you read.

The Shoulder Map

Pick Your
Sore Spot

For reference
Back view of the shoulder showing the deltoid, rotator cuff muscles, shoulder blade and collarbone
Back view of a right shoulder. The rotator cuff is the deep layer of four muscles wrapping the ball of the joint, mostly hidden here under the big deltoid.
ClickTapWhere It Hurts

Pick the spot on your shoulder that hurts. You’ll get the conditions that live there, the clues that tell them apart, and the stretches and exercises for each one.

Outside of the shoulder

The Outer Shoulder and Upper Arm

This is where most shoulder pain lives. It usually sits on the outside of the shoulder and runs down into the upper arm, sometimes as far as the elbow but almost never past it. Nearly all of it involves the rotator cuff and the narrow space it runs through.

Narrow It Down

Four problems share this address. What separates them is weakness, suddenness, and whether it wakes you at night.

1
Most common
Rotator Cuff TendinopathySubacromial pain syndrome, once called impingement
Painful arcOverhead and behindNight pain on that side
The outer shoulder into the upper arm, often down to where the deltoid attaches. Rarely past the elbow.
Most likely yours if
  • A painful arc: raising the arm hurts between about 60 and 120 degrees, then eases at the top
  • Reaching overhead, or behind you into a jacket sleeve, reproduces it
  • Lying on that side at night is uncomfortable
  • Strength is close to normal once you work past the pain
Stretches · daily
Exercises · every other day
Do
  • Keep using the arm below shoulder height. Total rest stiffens it up
  • Load the cuff three times a week. Bands are enough, this is a strength problem
  • Sleep with a pillow hugged under the sore arm to take the stretch off it
Don’t
  • Do overhead presses, behind-the-neck pulldowns or upright rows while it is angry
  • Get a cortisone shot and go straight back to whatever caused it
  • Expect it gone in three weeks. Give it eight to twelve
2
Shoulder BursitisSubacromial bursitis
Sharper than an acheHurts most movementsOften after overhead work
The same outer shoulder region, but the pain is sharper and more constant rather than a movement-specific ache.
Most likely yours if
  • It hurts through most of the range, not just one arc
  • Sharp rather than dull, and it can throb at rest
  • It flared after a burst of overhead work like painting a ceiling
  • Very tender to press on the outer point of the shoulder
Stretches · daily
Exercises · every other day
Do
  • Calm it down first with pendulums and gentle range, then start loading
  • Ice 10 to 15 minutes after activity while it is still sharp
  • Work below shoulder height for the first week or two
Don’t
  • Push into sharp pain hoping to break through it
  • Do repeated overhead work until the sharpness settles
  • Stop the strengthening as soon as it feels better. That is how it returns
3
Rotator Cuff TearPartial or full-thickness cuff tear
Weakness, not just painOften after a fallOver 60 or a heavy lift
Same outer shoulder pain, but the headline is weakness. Pain and weakness are different problems, and this one brings both.
Most likely yours if
  • You cannot hold the arm out to the side. It drifts down even after someone lifts it there for you
  • The weakness is obvious, not just guarding against pain
  • It started with a fall, a catch, or a heavy lift
  • Night pain is significant
Stretches · daily
Exercises · every other day
Do
  • Get it examined. Tears are graded and the grade changes the whole plan
  • Start gentle range and shoulder blade work in the meantime
  • Know that most partial tears do well without surgery
Don’t
  • Load it heavily overhead before someone has tested the strength
  • Assume the weakness is only pain holding you back
  • Wait months if the arm genuinely will not lift
4
Calcific TendinitisCalcific tendinopathy of the rotator cuff
Sudden and severeAges 30 to 60Barely movable
Outer shoulder, but the story is unmistakable: severe pain that arrived out of nowhere, often overnight.
Most likely yours if
  • It came on suddenly and intensely with no injury to explain it
  • The pain is wildly out of proportion to anything you did
  • You can barely move the arm in any direction
  • Typically somewhere between 30 and 60 years old
Stretches · daily
Exercises · every other day
Do
  • Get seen. This phase often needs medical management and imaging confirms it
  • Pendulums and gentle motion only for the first few days
  • Know the acute phase usually settles within days to a couple of weeks
Don’t
  • Try to stretch or strengthen through the acute phase
  • Assume you have torn something
  • Just suffer through it. This is one where medical help genuinely shortens the misery
Self-checks you can do right now

The painful arc test. Slowly raise your arm out to the side. If pain appears around 60 to 120 degrees and then eases as you keep going up, that is a classic cuff and bursa pattern.

The night test. Can you sleep on that side? Consistent night pain moves the rotator cuff and frozen shoulder up the list, and moves simple muscle strain down it.

The drop-arm test. Have someone lift your arm out to shoulder height and let go. If it drops, or you cannot lower it under control, that is weakness rather than pain and it needs an exam.

In the meantime
  • Keep the arm moving below shoulder height. A shoulder that stops moving gets stiff quickly, and stiffness is harder to fix than soreness.
  • Change how you sleep. Lie on the good side with a pillow hugged in front to support the sore arm, or sleep semi-reclined.
  • Rearrange your reach. Move the everyday things out of the top cupboard for a few weeks.
  • Load it three times a week. Bands are plenty. The cuff responds to consistent loading, not to rest.
  • Give it eight to twelve weeks. Cuff problems are slow. The people who do well are the ones still doing their bands in week six.
Stop and get it looked at if

You cannot lift the arm at all, it gave out suddenly after a fall, or there is real weakness rather than pain. That needs an exam before any program.

Front of the shoulder

The Front of the Shoulder

Front-of-shoulder pain is usually one of two things: a biceps tendon running through its groove, or the front part of the rotator cuff. Both respond well. The one worth catching early is instability, because that one is made worse by the stretching most people instinctively do.

Narrow It Down

The front is a small area, so which movement reproduces it matters more than exactly where your finger lands.

1
Most common in front
Biceps Tendon PainLong head of biceps tendinopathy
Tender cord in the groovePalm-up liftingReaching forward
A tender cord in the groove at the front of the shoulder, an inch or two below the very top. You can usually find it with one finger.
Most likely yours if
  • Pressing that groove reproduces your exact pain
  • Lifting something palm-up, or reaching straight forward, sets it off
  • Carrying a bag or a car seat aggravates it
  • Often travels a short way down the front of the arm
Stretches · daily
Exercises · every other day
Do
  • Load it slowly. Tendons want progressive work, not rest
  • Carry things closer to your body and with the palm turned in
  • Build the rotator cuff too. The biceps tendon usually gets overloaded because the cuff is not doing its share
Don’t
  • Do heavy palm-up curls or front raises while it is irritable
  • Stretch it aggressively at the front of the shoulder
  • Ignore it for months. It often signals a cuff problem behind it
2
Front Cuff StrainSubscapularis strain or tendinopathy
Deep and toward the armpitReaching behind your backWeak pushing inward
Deep in the front of the shoulder, closer to the armpit crease than to the bony point on top.
Most likely yours if
  • Tucking in a shirt or reaching for a back pocket is the worst movement
  • Pushing your palm into your belly with force feels weak or sore
  • Reaching behind the back is limited compared to the other side
  • Often follows a fall on an outstretched arm
Stretches · daily
Exercises · every other day
Do
  • Work internal and external rotation both. The cuff is a ring, not a single muscle
  • Regain reach-behind-the-back range gradually
  • Keep loads close to the body while it settles
Don’t
  • Force the arm behind your back to stretch it
  • Bench press heavy through the painful range
  • Assume it is just a strain if there is real weakness
3
Shoulder InstabilityAnterior instability or labral irritation
Feels like it might slipYoung or overhead athleteClicking or dead arm
Deep in the front, with a distinct sense that the shoulder could move somewhere it should not.
Most likely yours if
  • There is a feeling of apprehension when your arm is out and rotated back, like in a throwing position
  • You are younger, or you play an overhead or contact sport
  • Clicking, catching, or an occasional dead-arm feeling
  • Possibly a previous dislocation or subluxation
Stretches · daily
Exercises · every other day
Do
  • Build the cuff and the shoulder blade muscles. Stability is a strength problem here
  • Get it assessed, especially if it has dislocated before
  • Strengthen through the mid-range first, then work outward
Don’t
  • Stretch it. A loose shoulder does not need more range
  • Do overhead pressing or wide-grip bench while it feels unstable
  • Return to throwing or contact before the strength is back
4
Pec StrainPectoralis major strain
There was a momentBench press or a fallBruising
The front of the shoulder running into the chest, along the fold of the armpit.
Most likely yours if
  • It happened in a specific moment, usually a heavy bench press or a fall
  • There may be bruising or a visible change in the muscle shape
  • Pressing movements hurt most
  • Stretching the arm backward pulls at the front
Stretches · daily
Exercises · every other day
Do
  • Rest from pressing for the first week or two, then rebuild gradually
  • Get a visible deformity or a loud pop assessed promptly
  • Return to bench pressing with light weight and a narrower grip
Don’t
  • Stretch it hard in the first week
  • Test it by benching heavy to see if it still hurts
  • Ignore a sudden pop with bruising. Full tears need surgical review
Self-checks you can do right now

Find the groove. With your arm relaxed at your side and the palm forward, press just below the bony point at the front of the shoulder. A tender cord there is the biceps tendon.

The back-pocket test. Reach behind your back as if for a wallet. If that is the limited and painful movement, the front of the cuff is involved.

The apprehension check. Raise your arm out to the side and rotate it back like you are about to throw. A feeling that the shoulder might slip, rather than pain, points to instability and changes the plan completely.

In the meantime
  • Keep loads close to your body. Carrying anything out in front multiplies the load on the front of the shoulder.
  • Turn your palm in. Palm-up lifting loads the biceps tendon directly. Palm-in takes it off.
  • Pause the pressing. Bench press, dips and push-ups can wait two or three weeks.
  • Do not stretch a loose shoulder. If it feels unstable rather than tight, stretching makes it worse. Strengthen instead.
  • Give tendons time. Eight to twelve weeks of consistent loading is the realistic timeline.
Stop and get it looked at if

A sudden pop with bruising and a change in the muscle shape, or a shoulder that has actually dislocated. Both need prompt assessment.

Top of the shoulder

The Top of the Shoulder

The top of the shoulder is the easiest region to sort out, because the AC joint is a small target you can put one finger on. If your finger lands on the bony bump, it is that joint. If you find yourself rubbing the slope between your neck and shoulder instead, you are in different territory entirely.

Narrow It Down

One question settles most of this: can you point to it with one finger, or do you rub a whole area?

1
Most common on top
AC Joint SprainAcromioclavicular joint sprain or separation
Point on the bumpOften after a fallReaching across hurts
Right on the bump at the very top of the shoulder, where the collarbone meets the shoulder blade. You can cover it with one fingertip.
Most likely yours if
  • You can point to it with one finger and pressing there reproduces it exactly
  • It followed a fall onto the shoulder, or a hit in sport
  • Reaching across your body to the opposite shoulder is the worst movement
  • There may be a visible step or lump at the end of the collarbone
Stretches · daily
Exercises · every other day
Do
  • Get a visible step or lump assessed. Separations are graded and grade drives the plan
  • Keep the arm moving below shoulder height while it settles
  • Rebuild the shoulder blade muscles once the sharp phase passes
Don’t
  • Do the cross-body stretch. It compresses exactly the joint that hurts
  • Bench press, dip, or do heavy overhead work for a few weeks
  • Sleep on that shoulder while it is acute
2
AC Joint ArthritisAcromioclavicular osteoarthritis
Same spot, no injuryOver 40Aches after lifting
The same bump on top, but without any injury to explain it. It crept up over months or years.
Most likely yours if
  • Past about 40, and there was no fall or single event
  • Bench press, dips and reaching across the body all aggravate it
  • A dull ache that lingers for hours after lifting
  • Tender to press, sometimes with a small firm bump
Stretches · daily
Exercises · every other day
Do
  • Change the exercises rather than stopping. Narrow the grip, reduce the depth
  • Keep training. Load in a comfortable range is good for an arthritic joint
  • Build the shoulder blade and cuff so the joint is better supported
Don’t
  • Do deep dips, wide-grip bench, or the cross-body stretch
  • Chase it with stretching. This joint does not need more range
  • Assume it means you have to stop lifting. It usually just means adjusting
3
Weightlifter’s ShoulderDistal clavicle osteolysis
End of the collarboneHeavy bench and dipsAches after training
The very end of the collarbone, just inside the AC bump. Common in people who bench and dip heavy and often.
Most likely yours if
  • A history of heavy pressing, dips, or Olympic lifting
  • A deep ache in the end of the collarbone that shows up hours after training
  • Tender to press right on the bone
  • More common in men in their twenties and thirties
Stretches · daily
Exercises · every other day
Do
  • Deload the pressing volume substantially for six to eight weeks
  • Switch to neutral-grip and floor presses that limit the bottom range
  • Get an X-ray if it is not settling. This one shows up on imaging
Don’t
  • Train through it. This is a bone stress problem, not a soft tissue one
  • Keep doing deep dips and wide-grip bench
  • Expect it to resolve in two weeks. It is slow
4
Neck and Trap ReferralCervicogenic or myofascial referred pain
The slope, not the jointDesk and stressNeck movement changes it
The slope between your neck and the point of your shoulder, rather than the bony bump itself.
Most likely yours if
  • You cannot point at one spot. It is a broad band of aching
  • Turning or tilting your neck changes it
  • Worse at the end of a desk day, or during stressful weeks
  • Shoulder movements themselves are basically fine
Stretches · daily
Exercises · every other day
Do
  • Fix the desk. Screen at eye height, elbows supported
  • Take a two-minute movement break every hour
  • Strengthen the mid-back. Stretching alone rarely holds
Don’t
  • Only stretch it. The relief lasts about twenty minutes without strength work
  • Sit for three hours straight because you are in flow
  • Ignore numbness or tingling running down the arm. That is a different problem
Self-checks you can do right now

The one-finger test. Put one finger on the sore spot. Landing on the bony bump where the collarbone ends means the AC joint. Rubbing the muscular slope toward the neck means it is coming from the neck and trapezius.

The cross-body test. Reach across your chest and pull the arm toward the opposite shoulder. Sharp pain on top of the shoulder is a strong AC joint sign.

The neck test. Turn and tilt your head away from the sore side. If that changes the pain, your neck is involved and the shoulder may be innocent.

In the meantime
  • Skip the cross-body stretch. It is the standard shoulder stretch, and it squeezes the AC joint. If the top hurts, leave it out.
  • Narrow your grip. On bench press and push-ups, a narrower grip takes load off the AC joint.
  • Lose the deep dips. Dips at depth are the single most provocative exercise for this joint.
  • Set the desk up properly. If it is neck referral, the desk is the treatment.
  • Get a visible step checked. A lump or step at the end of the collarbone after a fall should be graded.
Stop and get it looked at if

A visible step or lump at the end of the collarbone after a fall, or pain with numbness and tingling running down the arm.

Back of the shoulder

The Back of the Shoulder and Shoulder Blade

Pain back here splits neatly in two. Either it is genuinely the shoulder, which usually means the back of the rotator cuff in someone who throws or works overhead, or it is coming from the neck and the muscles around the shoulder blade. The tingling question sorts it out fast.

Narrow It Down

Start with the nerve question. Any tingling or numbness below the elbow moves the neck to the top of the list, whatever the shoulder is doing.

1
Check this first
Pinched Nerve In The NeckCervical radiculopathy
Tingling below the elbowNeck changes itWorse looking up
Felt around the shoulder blade and back of the shoulder, often travelling down the arm. The source is the neck.
Most likely yours if
  • Numbness, tingling or pins and needles below the elbow, especially into the hand
  • Looking up, or turning toward the sore side, makes it worse
  • Sometimes relieved by putting your hand on top of your head
  • The shoulder itself moves fine when you test it in isolation
Stretches · daily
Exercises · every other day
Do
  • Treat the neck, not the shoulder. Chasing the shoulder here goes nowhere
  • Get it examined, especially if there is weakness in the hand or arm
  • Avoid positions that provoke it while it calms, usually looking up and forward head posture
Don’t
  • Aggressively stretch the neck toward the painful side
  • Ignore progressive weakness, dropping things, or numbness that keeps spreading
  • Assume a normal shoulder exam means nothing is wrong
2
Back Cuff TendinopathyInfraspinatus and teres minor tendinopathy
Throwers and overheadHurts deceleratingTender behind the joint
The back of the shoulder itself, over the meaty part just behind the joint, not out on the shoulder blade.
Most likely yours if
  • You throw, swim, serve, or do a lot of overhead work
  • It hurts most on the deceleration phase, slowing the arm down after a throw
  • Tender to press on the back of the shoulder
  • Reaching across your body to the opposite side pulls at the back
Stretches · daily
Exercises · every other day
Do
  • Work internal rotation range. Throwers almost always lose it on the throwing side
  • Build eccentric strength, slow lowering on every rep
  • Cut throwing or serving volume by about a third for two to three weeks
Don’t
  • Return to full-velocity throwing before the strength work is comfortable
  • Skip the sleeper stretch. Lost internal rotation is usually part of the problem
  • Only stretch. This needs loading too
3
Shoulder Blade WeaknessScapular dyskinesis and periscapular weakness
Between blade and spineDesk workAching, not sharp
Between the shoulder blade and the spine, a deep aching that builds through the day.
Most likely yours if
  • An ache that builds over hours rather than a sharp movement-specific pain
  • Worst at the end of a long day at a computer
  • The shoulder blade may wing out or ride up when you raise the arm
  • Better on days you move more, worse on days you sit
Stretches · daily
Exercises · every other day
Do
  • Strengthen the mid-back. This is a strength and endurance problem, not a tightness problem
  • Break up sitting every hour. Two minutes is enough
  • Set the screen at eye height and support the elbows
Don’t
  • Rely on stretching and massage alone. Relief lasts about as long as the session
  • Sit for three hours straight
  • Expect a quick fix. Postural endurance takes six to eight weeks to build
4
Trigger Point PainMyofascial pain, often levator scapulae
A knot you can findTop inner cornerRefers up the neck
A tight knot at the top inner corner of the shoulder blade, which you can usually locate with a thumb.
Most likely yours if
  • You can find a distinct tender knot and pressing it recreates the pain
  • It refers upward into the neck or toward the base of the skull
  • Stress and poor sleep make it noticeably worse
  • Range of motion at the shoulder is normal
Stretches · daily
Exercises · every other day
Do
  • Use a ball against a wall on the knot for 60 to 90 seconds
  • Follow the release with strengthening, or it comes straight back
  • Look at sleep and stress. They drive this more than people like to admit
Don’t
  • Dig into it hard for ten minutes. More pressure is not better
  • Treat it purely as a massage problem
  • Ignore it if it comes with headaches. That is worth a proper look
Self-checks you can do right now

The tingling question. Any numbness, tingling or pins and needles below the elbow? That points at the neck, not the shoulder, and it changes everything that follows.

The neck test. Turn your head toward the sore side and look up. If that reproduces the pain, the neck is involved.

The internal rotation check. Lying on the sore side with the arm out at 90 degrees, rotate the forearm down toward the floor. Compare sides. Throwers usually lose a lot of range here and that loss drives back-of-shoulder pain.

In the meantime
  • Answer the nerve question first. Tingling below the elbow means the neck gets treated, not the shoulder.
  • Fix the workstation. Screen at eye height, elbows supported, feet flat. This is treatment, not advice.
  • Move every hour. Two minutes of movement beats an hour of stretching at the end of the day.
  • Strengthen the mid-back. Scapular squeezes and prone I-T-W-Ys, three times a week.
  • Throwers, cut volume. Drop throwing or serving by about a third for two to three weeks while you build the cuff.
Stop and get it looked at if

Weakness in the hand or arm, numbness that keeps spreading, or you are dropping things. That needs prompt assessment.

Deep or worse at night

Deep In The Joint, Or Waking You Up

When you cup the whole shoulder instead of pointing at it, and especially when it wakes you at night, the list changes. These are the bigger problems. The good news is that one simple test separates most of them, and once in a while the shoulder is not the source at all.

Narrow It Down

The test that matters most here: can someone else move your arm further than you can? If not, think frozen shoulder. If they can, think cuff.

!
Rule this out first
Shoulder Pain That Is Not The ShoulderReferred pain from the heart, lungs, gallbladder or diaphragm
Chest pressureShort of breathComes on with exertion
Usually the left shoulder or the top of either shoulder, with nothing reproducible when you move the arm.
Get emergency care if
  • Chest pressure or tightness, shortness of breath, sweating, nausea or lightheadedness. Call 911.
  • The pain comes on with exertion like climbing stairs and eases with rest
  • Moving, pressing or positioning the shoulder does not change it at all
  • Right shoulder tip pain with belly pain after fatty meals can be the gallbladder
Do
  • Treat chest pressure with shortness of breath as an emergency. Call 911, do not drive yourself
  • Tell someone if you have risk factors: high blood pressure, diabetes, smoking, family history
  • Get right shoulder tip pain with abdominal symptoms evaluated the same week
Don’t
  • Stretch it, ice it, or wait to see if it passes
  • Assume it must be muscular because it is in your shoulder
  • Drive yourself to hospital
1
Most common
Frozen ShoulderAdhesive capsulitis
Motion lost, not just painfulAges 40 to 60Diabetes raises the risk
Deep and everywhere. You cannot point to it. The defining feature is not the pain, it is the lost motion.
Most likely yours if
  • Someone else cannot move your arm any further than you can. This is the single most useful sign
  • Reaching behind your back and rotating the arm outward are the first movements lost
  • Between about 40 and 60, and more common with diabetes or thyroid disease
  • It hurts badly at night, and it came on gradually with no clear injury
Stretches · daily
Exercises · every other day
Do
  • Work range of motion daily, little and often. Five minutes four times a day beats twenty once
  • Get the diagnosis confirmed. The treatment is genuinely different from a cuff problem
  • Understand the timeline: freezing, frozen, then thawing, often 12 to 18 months total
Don’t
  • Force it aggressively in the painful freezing phase. That makes it angrier
  • Let the arm stop moving. Motion is the whole treatment
  • Expect a quick fix. Steady daily work is what changes this one
2
Shoulder ArthritisGlenohumeral osteoarthritis
Over 60GrindingGradual stiffness
Deep inside the ball and socket, a diffuse ache that has built over years.
Most likely yours if
  • Past about 60, and it has come on gradually over years
  • A grinding or grating feeling when you move the arm
  • Stiff in the morning, easing after twenty or thirty minutes
  • Aches after use and often at night
Stretches · daily
Exercises · every other day
Do
  • Keep it moving daily. An arthritic joint stiffens fast when it is spared
  • Strength train it two or three times a week within a comfortable range
  • Warm it up before activity rather than after
Don’t
  • Rest it because it aches. Stiffness and weakness both accelerate
  • Do heavy overhead pressing
  • Assume nothing can be done. Strength and range work reliably help
3
Large Cuff TearFull-thickness or massive rotator cuff tear
Cannot lift the armSevere night painWeakness is the story
Deep and diffuse, with weakness that is impossible to miss.
Most likely yours if
  • You cannot raise the arm against gravity, or it shrugs upward instead
  • Night pain is severe and consistent
  • It may have followed a fall, or built up over years in an older shoulder
  • Someone else can move the arm further than you can move it yourself
Stretches · daily
Exercises · every other day
Do
  • Get it examined and imaged. Timing matters more with large tears
  • Keep passive range going with pendulums in the meantime
  • Ask specifically about the difference between a repairable and a non-repairable tear
Don’t
  • Spend six months on exercises before anyone has looked at it
  • Load it overhead
  • Confuse this with a frozen shoulder. In a frozen shoulder someone else also cannot move it. Here they can
Self-checks you can do right now

The passive motion test. Let your arm go completely limp and have someone else raise it and rotate it outward. If they cannot move it further than you can, that points strongly at a frozen shoulder. If they can move it much further, the problem is the cuff.

The night test. Consistent pain that wakes you, or stops you sleeping on that side, belongs in this group and deserves a real exam.

The rule-out. Does moving, pressing or repositioning the shoulder change the pain at all? If nothing you do to the shoulder makes any difference, the pain may not be coming from the shoulder.

In the meantime
  • Move it every day. With frozen shoulder and arthritis both, daily range work is the treatment. Little and often.
  • Sort out sleep. Semi-reclined, or on the good side with a pillow supporting the sore arm in front of you.
  • Warm up first. A hot shower before your range work makes it noticeably easier.
  • Get a diagnosis. This group is where guessing costs you the most. Frozen shoulder and a cuff tear need opposite approaches.
  • Be realistic on timeline. Frozen shoulder is often 12 to 18 months. Knowing that up front makes it much easier to stick with.
Stop and get it looked at if

Chest pressure, shortness of breath, sweating or nausea. Call 911. Also get seen promptly for an arm you cannot lift at all, fever with a hot swollen shoulder, or pain following significant trauma.

The Movements

Stretches &
Exercises

Every movement referenced above, in one place, with a video demo. Nothing here should reproduce sharp shoulder pain. Work in the range that feels clean and let it expand week by week. Two rules govern all of it, and they are spelled out right after this section.

Stretches and range of motion

Daily is fine, and in a stiff shoulder little and often beats one long session.

Codman Pendulum demonstrationWatch demo
01
Codman Pendulum
Lean forward with the sore arm hanging free and let it swing in small circles. Do not drive it with the shoulder, let gravity do the work. The single best thing to do in an angry, acutely painful shoulder.
30 to 60 seconds each direction
Cross-Body Stretch demonstrationWatch demo
02
Cross-Body Stretch
Bring the sore arm across your chest and draw it in with the other hand. Opens the back of the shoulder. Skip this one if the pain is on top of the shoulder, because it compresses the AC joint.
Hold 30s · 3x
Sleeper Stretch demonstrationWatch demo
03
Sleeper Stretch
Lie on the sore side with the arm out at 90 degrees, then gently rotate the forearm down toward the floor. Restores internal rotation, which throwers and overhead workers almost always lose.
Hold 30s · 3x
Table Slides demonstrationWatch demo
04
Table Slides
Rest the forearm on a table and slide forward, letting the shoulder move without the muscles having to lift the arm. The safest way to keep range in a very painful or frozen shoulder.
2 sets of 10
Doorway Pec Stretch demonstrationWatch demo
05
Doorway Pec Stretch
Forearm on the door frame at shoulder height, then step through gently. Opens the chest so the shoulder blade can sit back where it belongs.
Hold 30s · 3x
Upper Trapezius Stretch demonstrationWatch demo
06
Upper Trapezius Stretch
Ear toward the opposite shoulder, with the hand on the sore side tucked behind your back. Ease into it, no pulling hard.
Hold 30s · 3x each side

Strengthening

Every other day. A light resistance band is all you need to start.

Band External Rotation demonstrationWatch demo
01
Band External Rotation
Elbow tucked at your side with a towel under it, rotate the forearm outward against a band. Slow back. The most important exercise on this page.
3 sets of 12
Scapular Squeezes demonstrationWatch demo
02
Scapular Squeezes
Draw the shoulder blades back and slightly down, hold, release. Simple, and the foundation everything else is built on.
3 sets of 12 · hold 3s
Band Scaption & Rows demonstrationWatch demo
03
Band Scaption & Rows
Raising the arm in the plane of the shoulder blade, plus rowing. Builds the strength that lets you get back overhead.
3 sets of 12
Prone I-T-W-Y demonstrationWatch demo
04
Prone I-T-W-Y
Face down, lift the arms into each of the four letter shapes. Hits the mid-back and lower trapezius, the muscles a desk job quietly switches off.
2 to 3 sets of 8 each letter
Rotator Cuff Band Set demonstrationWatch demo
05
Rotator Cuff Band Set
A full rotator cuff circuit with a band, covering rotation in both directions. Use this once single exercises feel easy.
2 rounds
Full Shoulder Routine demonstrationWatch demo
06
Full Shoulder Routine
A complete seven-exercise rehab sequence. Use this once you know which diagnosis you are working with and the individual movements feel comfortable.
2 to 3x per week
Two Rules

How To Know If
You’re Doing Too Much

These two rules apply to every program on this page, wherever your pain is. They are the same ones I give patients in the office, and they replace the guesswork about whether to push through something.

1
The 3 out of 10 rule

Some discomfort during these exercises is normal and even useful. Pain above about a 3 out of 10 is not. If an exercise pushes past that, reduce the range, the band tension, or the number of reps.

2
The 24-hour rule

Your shoulder should be back to its normal baseline within 24 hours. If it is more sore the next morning, or it kept you awake, you did too much. Cut the volume roughly in half and rebuild from there.

Shoulders are slower than knees
Rotator cuff problems typically take 8 to 12 weeks of consistent loading, and a frozen shoulder can run 12 to 18 months through its full cycle. That is not a sign anything is going wrong, it is simply the timeline. The people who do well are the ones still doing their bands in week six, when nothing much has visibly changed yet. If you are twelve weeks in with no change at all, that is your signal to get examined rather than to train harder.
Don’t Wait On These

Signs You Should
Skip the Exercises

Almost every shoulder I see does well with the right loading. These are the exceptions.

Chest pressure or tightness, shortness of breath, sweating or nausea. Call 911. This is not a shoulder problem
You cannot lift the arm at all, or it drops when someone lets go of it
The shoulder dislocated, or there is a visible change in its shape
Numbness, tingling or weakness running down the arm, or you are dropping things
A hot, swollen shoulder with a fever. That is urgent
Pain following significant trauma such as a fall from height or a car accident
A visible step or lump at the end of the collarbone after a fall
Pain that does not change at all no matter how you move or press the shoulder
Not sure which one you’ve got? That is exactly what a first visit is for.
Book an Exam
Common Questions

Shoulder Pain
Questions

What does pain on the outside of my shoulder mean?

Most often rotator cuff tendinopathy, also called subacromial pain syndrome. The giveaway is a painful arc: raising the arm out to the side hurts between roughly 60 and 120 degrees and then eases at the top. It also tends to hurt reaching overhead or behind you, and to bother you when you lie on that side at night. If the arm is genuinely weak rather than just painful, that points instead to a rotator cuff tear.

Why does my shoulder hurt more at night?

Night pain is one of the most useful clues in the shoulder. Lying down removes the support the arm normally gets and lets the joint settle in a position that compresses the cuff, and there are no distractions to compete with the pain. Consistent night pain moves rotator cuff problems and frozen shoulder up the list. Try sleeping on the good side with a pillow hugged in front of you to support the sore arm, or semi-reclined.

How do I know if I have a frozen shoulder?

One test separates it from almost everything else: have someone else move your arm while you keep it completely relaxed. In a frozen shoulder they cannot move it any further than you can, because the joint capsule itself has tightened. With a rotator cuff problem they can usually move it much further than you can. Frozen shoulder typically shows up between 40 and 60, is more common with diabetes, and takes away outward rotation and reaching behind the back first.

What is the pain on top of my shoulder?

If you can cover it with one fingertip and it sits on the bony bump where the collarbone meets the shoulder, that is the AC joint, either sprained after a fall or arthritic if it came on gradually. Reaching across your body makes it worse. If instead you find yourself rubbing the muscular slope between your neck and shoulder, the pain is coming from the neck and trapezius rather than the joint.

Can shoulder pain come from my neck?

Yes, and it is a common miss. The tell is numbness, tingling or pins and needles below the elbow, and pain that changes when you turn or tilt your neck. Cervical radiculopathy, a pinched nerve in the neck, frequently presents as pain around the shoulder blade and back of the shoulder. If that describes you, the neck needs treating and shoulder exercises will not get you far.

Should I stretch or strengthen a painful shoulder?

It depends on the diagnosis, which is exactly why this page separates them. A stiff shoulder like adhesive capsulitis needs daily range of motion work. A rotator cuff problem needs progressive strengthening more than stretching. A shoulder that feels unstable should not be stretched at all, since it does not need more range. Getting this backwards is one of the most common reasons shoulder pain drags on.

How long does shoulder pain take to get better?

Rotator cuff problems usually need 8 to 12 weeks of consistent loading. AC joint sprains often settle in 4 to 6 weeks depending on the grade. Frozen shoulder is the long one, commonly 12 to 18 months through freezing, frozen and thawing phases. Progress is rarely linear, and week three often feels like nothing is happening. If you are twelve weeks in with no change, get examined.

When should I see someone about shoulder pain?

Get evaluated if you cannot lift the arm at all, there is obvious weakness rather than pain, the shoulder has dislocated, or you have numbness and tingling down the arm. Chest pressure, shortness of breath, sweating or nausea with shoulder pain is a 911 call, not a shoulder problem. Also get seen for a hot swollen shoulder with fever, or pain that follows significant trauma.

Can a chiropractor help with shoulder pain?

Yes. Shoulder pain is often driven by the neck, the mid-back and the way the shoulder blade moves, which is exactly what a full exam looks at. Dr. Loewenstein assesses the shoulder along with everything connected to it, uses hands-on care to restore motion and calm irritated tissue, and builds the loading program that actually resolves it. Treatment starts on the first visit at the UTC San Diego office.

UTC San Diego · Mon–Fri 9am–7pm · Sun 10am–4pm

Find Out What’s
Actually Going On

Narrowing it down by location gets you most of the way there. A hands-on exam gets you the rest of the way, and treatment starts on visit one.

Book an Appointment(858) 558-3111
5151 Shoreham Place, Suite 175 · UTC San Diego, CA 92122 · Near UCSD
JL
Dr. Jordan Loewenstein, D.C.
D.C. · M.S. Nutrition · ART Certified · Webster Certified · sdspinecare.com
Clinically reviewed August 2026
Related Pages
Foam Rolling: How to Do It RightFull Shoulder ProgramKnee Pain by LocationExercise & Stretch LibraryNeck Pain ExercisesAbout Dr. Loewenstein
This page is general educational information and is not a substitute for a professional diagnosis or individualized medical advice. Pain location narrows the possibilities, it does not confirm a diagnosis. Stop any exercise that causes sharp pain. If you cannot lift the arm, the shoulder has dislocated, you have numbness or weakness running down the arm, or you develop chest pressure and shortness of breath, seek medical care immediately.