Shoulder Pain
Why does my shoulder hurt when I reach overhead?
What the painful reach can tell us
The rotator cuff is a group of muscles and tendons that helps move and support the shoulder. Pain during a reach can involve the cuff. A shoulder that progressively loses motion even when someone else gently moves it may need a different assessment, including a check for frozen shoulder. Symptoms traveling down the arm can also prompt a neck screen. [1, 2, 3]
How I decide what to change
I’ll ask which reach matters to you and what you’ve already tried. We might check how far you can reach, what happens with resistance, and whether changing the position of your arm or shoulder blade changes the movement. If we try a hands-on technique, we can repeat the same reach during the visit. I also want to know how it feels when you’re putting dishes away the next day. [4]
Building back to the task
We can start with a reach or exercise you tolerate and progress the height, weight, or number of repetitions as needed. In the GRASP trial, a multi-session progressive program did not outperform a single best-practice advice session over 12 months. How much guidance you need depends on what you’re trying to return to and how it’s going. [5, 6]
Frequently asked questions
Why can I reach the top shelf, but grabbing my seat belt hurts?
Those two reaches give us something to compare. Show me where the seat-belt reach starts to hurt. We can change how far back you reach or how you turn, then try it again. What you feel tells me what to check next.
The reach felt easier here. Will I notice it the next time I get in the car?
Use your usual seat-belt reach as the comparison. Notice where the discomfort begins and whether you still hesitate before reaching. That helps us judge how much of the change made it home with you.
Why does my arm feel fine reaching for a mug but hurt putting it back?
I’d ask you to show me both directions. We can compare lifting and lowering at a height and weight you tolerate, then use what you feel to choose which part of the reach to work on.
Why can I reach overhead once but struggle when I put away a stack of dishes?
Tell me when the reach starts changing. We can compare one comfortable reach with the point at which the task starts to feel harder, and use that to decide whether height, weight, or repetitions deserve the first look.
Do I need an MRI before I start?
The history and exam guide that decision. Imaging may help after certain injuries or when the result would change care. Rotator cuff tears also show up in people without pain, so we interpret a scan alongside what you feel and what you can do. [7, 8]
Does shoulder pain mean I need surgery?
It depends on the injury and exam. For persistent pain under the top of the shoulder, trials of one specific procedure, subacromial decompression, found no meaningful added benefit over placebo surgery. If an injury leaves you suddenly unable to lift your arm or noticeably weaker, get it checked promptly. [9, 10]
Why does it hurt more at night?
Tell me whether it starts when you lie on that side, wakes you in other positions, or is there throughout the day. Those differences help guide the assessment.
What if the retest feels exactly the same?
That gives us a reason to reconsider what we tried. We might change the range, support your arm differently, or check another movement before choosing what to work on.
What should I bring to the evaluation?
Bring one or two examples you want to get back to, like lifting a carry-on or sleeping on your side. If you have imaging or notes from an earlier injury, bring those too.