Shoulders love options and hate corners. Pain shows up when we lose rotation, load the wrong tissues, or spike volume (hello, weekend painting project or surprise pull-up challenge). Here’s a simple framework I use in clinic: regain motion, reinforce the cuff and scapula, then reload overhead work without poking the bear.
Quick Screen (At Home)
- Reach behind head: Compare sides; note pulling vs. sharp pain.
- Reach behind back: Thumb height difference? Pinch in the front?
- Wall slide: Can you raise arms without shrugging early?
Motion First
- Thoracic Extension over Foam/Chair: 8–10 reps.
- Posterior Capsule Stretch (Cross-body): 20–30s, easy.
- Pec Doorway Stretch: 2×30s each side.
Stability & Strength (Light to Start)
- Scapular Clocks: Wall-based, move shoulder blade without shrug; 6–8 each direction.
- External Rotation (band): Elbow tucked, 2×10.
- Prone Y/T/W: 6–8 of each with quality over quantity.
Return to Overhead
- Landmine Press: Friendly angle for grumpy shoulders.
- Half-Kneeling Press: Core on; no rib flare.
- Tempo Pull-Downs: Slow eccentrics teach control.
When to Seek Imaging/Referral
Trauma with weakness, night pain that doesn’t ease, or progressive loss of motion warrants medical workup. Otherwise, conservative care plus graded loading helps most non-traumatic shoulder pain.
CTA: Need an overhead on-ramp? Book with Dr. Edward Komberg—we’ll free motion, tune the cuff, and reintroduce lifts that respect your tissues.