How do I fix my shoulder pain?

Q: What does healthy shoulder blade movement look like?

It's the ability to move your shoulder blades by their own, without having to resort to repositioning your ribcage by arching, nor rounding your back, nor flaring your ribcage.

Q: How is the shoulder joint built?

Your shoulders have multiple joints acting in conjunction to provide the function we require. Yes your armbone (humerus) is the ball, that fits into the socket (the glenoid fossa, part of your shoulder blade), but that socket's position is determined by where your shoulderblade meets your collarbone. IF there is a movement restriction that does not allow you to properly position the socket, don't blame the ball inside that socket for the issues you're facing with your shoulder. On the other side of the same coin, if you're constantly putting unbalanced stress on your tissues surrounding your collarbone and scapula, your poor neck musculature eventually gets overloaded.

Q: What causes most shoulder and neck pain?

Majority of people suffering from neck/shoulder pain, that's come through our practice have demonstrated a lack of ability to move their shoulderblades through their full range of motion without having to resort to compensations by moving their ribcage, or the range of motion they have access to is FAR from the functional range of motion they require for pain free movement quality.

V, Founder of ALiGN Training

Oct 7

4 min read

Updated: Oct 20

TLDR; You don't have a Joint Problem, you have a Joint Positioning Problem.

Don't just treat the symptoms, look deeper into the systems that are producing the symptoms, to fix the underlying cause. Otherwise that same system will bring the symptoms right back!

Your shoulder is actually TWO separate joints working together;

The base is where your collar bone(clavicle) and your shoulderblade(scapula) meet, this is the socket.
The ball that is sitting inside this socket is your armbone(humerus), this is your TRUE shoulder joint.

The KEY to fixing the systemic issue, is addressing why the socket is poorly positioned, not why the ball does not move well in that poorly positioned socket.

Do not mistake that statement with a "stand up straight!" from your parent, or a "pull your shoulder blades back and down!" coming from your trainer. The systemic issues and their solution revolve around improving the balance between all the tissues that are controlling these structures, in all their positions.

So what's the solution? Assess and manage positioning & capacity, individually first (locally), then integrate into movement where multiple joints are involved (globally). This is your safest and easiest plan to get out of pain.

We give you the tools and resources to understand and apply these concepts in our "Mobility" Course under Controlled Articular Rotations.

What does healthy shoulder blade movement look like?

It's the ability to move your shoulder blades on their own, without having to resort to repositioning your ribcage by arching, nor rounding your back, nor flaring your ribcage. You should be able to do this with your arms at your sides, your arms out-front, out-to-the-sides, and most challenging version, with your arms overhead.

How is the shoulder joint built?

Labeled shoulder anatomy showing the clavicle (collarbone), scapula (shoulder blade) and humerus (armbone) that make up the shoulder joint

Your shoulders have multiple joints that have to be working together in order to provide the function we require. Yes the end of your armbone is the "ball", that fits into the "socket" (the glenoid fossa, part of your shoulder blade), but that socket's position is determined by where your shoulderblade meets your collarbone, and how they interact with your ribcage. We call this the ScapuThoracic Rhythm.

Most people are led to chase treating the symptoms of why the ball is not rotating properly in the socket, never looking to reposition the socket itself. IF there is a movement restriction that does not allow you to properly position the socket, don't blame the ball inside that socket for the issues you're facing with your shoulder.

This is the most common mistake in rehab, when you're pulling on bands that tries to treat the symptoms, instead of fixing the system at the root of the problem.

What causes most shoulder and neck pain?

All pain is caused by nerve irritation, nothing else has the ability to send signals to your central nervous system. Majority of people we have gotten out of shoulder pain lack control over their shoulderblades and their ribcage. This results in the pinching of the nerve bundle we have mentioned above, causing lack of sensation, pins & needles, numbness and pain.

Diagram of the nerves running from the neck through the shoulder, where poor shoulder blade position can pinch them and cause pain, pins and needles or numbness

Is my shoulder pain an injury or a positioning problem?

There is a portion of cases where shoulder pain comes from real tissue damage: bone, muscle, tendon, ligament or cartilage. After an acute injury, there's a period of inflammation and healing that needs to be respected. Once that has passed, controlled movement helps the area recover.

If your pain started with a fall, a pop, a sudden loss of strength, numbness, or pain that wakes you up at night, it never hurts to have an x-ray and/or an MRI.

For most people though, there was no single event. The pain built up over time from how the joint is positioned and conditioned. That's actually good news, because positioning and conditioning are things you can change.

How can I check my shoulder blade movement at home?

Stand side-on to a mirror, or have someone film you, and run through these. You're not looking for perfect. You're looking for what's moving that shouldn't be:

Slowly raise both arms overhead. Do your ribs flare forward or does your lower back arch to get there?
Shrug your shoulders up and down. Does your head or neck come along for the ride?
Squeeze your shoulder blades together, then spread them apart. Can you do it without your chest puffing out or your upper back rounding?
Compare sides. Does one shoulder blade lift, wing out or move less than the other?

If your ribcage or spine is doing your shoulder blade's job, that's the pattern to work on. This check is a starting point, not a diagnosis.

What daily habits help prevent shoulder pain?

Move through your full range every day. Even a few minutes counts. The body adapts to what it's fed, and most of our day keeps us in a limited range.
Change positions at your desk. Switch between sitting, kneeling and standing instead of holding one posture for hours.
Breathe into your ribcage. A ribcage that expands and moves gives your shoulder blades a better surface to glide on.
Cover your recovery basics. Quality sleep, good hydration and a regular soft-tissue routine.
Train smart. Learn the movement first, progress only to the level your body can handle today, and keep a clear goal in mind.

Next step

Want help finding where your shoulder is getting stuck? Work with us, or keep reading about how posture affects joint pain and why so many BJJ athletes hurt their shoulders.

This article is for education and isn't a substitute for an individual assessment. If you're in pain, get checked by a qualified professional.