Experiencing shoulder pain?

Brooke Carmen

Author: Brooke Carmen, PT, DPT: Doctor of Physical Therapy and Blog Contributor.  Loves fun informational gems.  Fitness addict and wannabe foodie. Emphasizes patient-specific treatment style and promotes goal-oriented care. Learn more about Brooke on here.


Do you have shoulder pain and don’t know why? Let’s talk about the most common causes of shoulder pain.

Shoulder pain classifies into two main categories: impingement or non-impingement syndromes. “Impingement” simply means that something is getting pinched and irritated in the shoulder. This could be a muscle tendon (where the muscle inserts into the bone) or a bursa (a fluid filled sac that decreases friction between muscles and bones).

Shoulder impingement, by far, is the most common cause of shoulder pain. Usually, people with shoulder impingement complain of pain when reaching overhead. It can present as diffuse, achey pain as well as sharp, shooting. Shoulder impingement can be caused by overworking the shoulder (i.e. painting overhead for hours) or by an abnormal bone shape.

Another common cause of shoulder pain is something called a tendinopathy. As previously mentioned, a tendon is the insertion of a muscle into a bone. A tendinopathy is a chronic irritation leading to degeneration of that tendon. This goes hand and hand with impingement syndrome, but it can sometimes present alone. Tendinopathies can be silent during activity, then flare afterwards. For example, a day of work may be okay, but then you may have a lot of diffuse shoulder pain at night.

Impingement syndromes and tendinopathies commonly occur in the rotator cuff. Most people have heard of the rotator cuff before, but do you know what it means? The rotator cuff is a term four muscles that control your shoulder joint. You can develope a tendinopathy of one of the rotator cuff muscles or you can pinch one of the muscles if you have impingement syndrome.

You can also tear your rotator cuff. This is more common in an older population (50-60’s and above). In a lot of cases, a rotator cuff tear is associated with a history of an injury (i.e. falling on the shoulder), but it can also present without an injury. It is associated with or without pain and always associated with weakness. If you are younger (teens to 30’s), your likelihood of a rotator cuff tear is low without a specific incidence when you remember hurting your shoulder with a lot of force.

These are some of the most common causes of shoulder pain seen in our physical therapy clinic, but there are other diagnoses not mentioned. Don’t self-diagnose your shoulder pain on the internet though, even with this blog. Talk to a physical therapist to help you come to a diagnosis. Most of shoulder pain is manageable without surgery, but in some cases it is not. A physical therapist can not only help answer whether or not you need to see a specialist (orthopedist), but can also help you get rid of your shoulder pain without surgery.