Tight Shoulders: What Causes Them and Exercises from PTs

If you’ve ever had shoulder pain, you know it’s no picnic. Everything from shampooing your hair in the shower or emptying the dishwasher to waving hello to a neighbor or playing a round of pickleball with friends can send a sharp zap of pain to your shoulder. One common culprit behind your shoulder pain: tight shoulder muscles. 

“The shoulder is a fascinating joint,” says Steven Goostree, PT, DPT, OCS, a physical therapist at Hinge Health. “It has a lot of range of motion and mobility, but there needs to be a healthy balance of both mobility and stability. Otherwise, you may develop tight shoulders and shoulder pain.” Here are some pro tips from Hinge Health physical therapists — including exercises — that can help relieve tight shoulders so you can get back to doing all the activities you love.

What Causes Tight Shoulders?

There are a few reasons you may experience tight shoulders. Just remember, no matter what the cause, there’s always something you can do to make sore shoulders feel better. That often starts with gentle stretches and exercise (more below).

A recent injury. “If you fall on your outstretched hand or face another type of injury that affects your shoulder, your body’s natural reaction is to tighten or tense everything up to protect it,” explains Dr. Goostree. This can also happen after a surgical procedure. “We even see stiffness and pain from neck or spine surgery refer — or travel — to the shoulder,” he adds. 

Osteoarthritis. Shoulder arthritis results in changes to the cartilage that covers the bones of your shoulder joint. Many things can contribute to shoulder arthritis and while these changes don’t always cause symptoms, they can contribute to pain and stiffness in some individuals, making it more difficult to lift your arm above your head. 

Sitting at your computer (without breaks). “Any sort of sustained posture can cause your shoulders to want to stiffen up,” explains Dr. Goostree. That’s why it’s common for people who sit at a computer for a long time to get tightness in the shoulder area. (This is why our physical therapists love recommending movement snacks — they’re a quick and effective way to reduce tightness and prevent pain from setting in.)

Stress. Next time you have a crazy, hectic day, take note of your shoulders. You may notice they’ve crept up closer to your ears. Stress and anxiety can naturally cause you to tense muscles in your entire body, and it can be especially common to tense shoulders and neck muscles. This isn’t necessarily a bad thing, but if you continue to tense up, it can contribute to prolonged pain and stiffness. (Check out this article for tips to reduce stress.) 

Overuse. If you’ve ever done an intense workout after some time away from the gym or tried a new sport, you may be familiar with those less-than-fun post-workout aches and pains. This type of pain rarely indicates an injury, but rather is your body’s way of saying you did a little too much too quickly. “I see patients all the time who didn’t play overhead sports like tennis or volleyball all winter, then join a summer league and end up with shoulder issues,” says Dr. Goostree. Getting active is a great thing for your health, including your shoulder health, but it helps to ease into a new activity and ramp up your intensity gradually to prevent straining your shoulder muscles. 

Benefits of Shoulder Exercises

If you have shoulder tension or pain, you may be tempted to pop an over-the-counter pain reliever and go about your day. But shoulder exercises (and other upper body moves) are really the best solution for preventing shoulder tightness over time, according to a 2020 review published in the Journal of Orthopedic & Sports Physical Therapy that looked at all current research about shoulder healing.

Here’s a closer look at some of the benefits of shoulder exercises:

• Strengthen shoulder muscles to help keep your shoulder joint stable

• Restore range of motion

• Reduce muscle soreness

• Keep muscles long and flexible

• Reduce the risk of muscle and joint injury

How to Prevent Tight Shoulders

When your shoulders feel tight, stiff, or achy, there are things that you can do to help relieve pain, and prevent the issue from returning. They include:

• Apply warm heat. This helps prepare shoulder tissues for range-of-motion exercises. The easiest way is to take a warm shower or bath for 10-15 minutes — this helps get to the deep location of some of your shoulder muscles and tendons. You can also use a moist heating pad.

• Adjust your lifting style. If you have tight shoulders, overhead lifting or reaching (or reaching behind you) can be difficult. This doesn’t mean that it’s a harmful movement, but it can still be really uncomfortable. Challenging your shoulder’s range of motion can help improve your pain, but it may help to temporarily adjust how you lift until your pain is more manageable. Try to keep objects close to your body and use both hands when lifting overhead. As you nudge into your pain and your shoulder’s range of motion increases, you can gradually return to your normal lifting style.  

• Adjust your workout. If you do chest and arm strengthening exercises, you may need to make some temporary tweaks when you’re dealing with an uptick in shoulder pain. Pushing exercises like push-ups, bench presses, chest flies, or shoulder presses, can be irritating for some people with shoulder pain. If that’s you, consider lightening your weight, doing fewer repetitions, or incorporating different exercises into your workout until your shoulder loosens up a bit. Then, gradually work your way back to your normal exercise routine.  

• Consider sleeping on your back. Sleeping on your side when you have tight shoulder muscles can be uncomfortable for some people, says Dr. Goostree. If you sleep on your side and wake up with more shoulder pain, try to sleep on your non-painful side or consider sleeping on your back for a short time. (Even switching your sleep position for a few hours of the night can make a difference.) You can keep an extra pillow under or behind your shoulder to help alleviate pressure. 

• Consider lumbar support. If you sit for long periods, whether at a desk, in a car, or somewhere else, you could consider using a lumbar support to help you maintain a natural curve in your lower back. “This helps keep your neck and shoulders in a neutral position,” Dr. Goostree explains, which can reduce shoulder tightness.

When to See a Doctor

Most of the time, shoulder tightness resolves on its own, especially if you do a home shoulder exercise program. But if it doesn’t improve after a couple of weeks, gets increasingly stiff with time, or pain and tightness worsen at night, consider talking to a doctor. They can prescribe physical therapy or may suggest alternative treatments as a supplement to an exercise therapy program. 

The following exercises recommended by Hinge Health physical therapists help improve shoulder mobility and loosen tight shoulders. Do these daily, suggests Dr. Goostree. “Take a few minutes for yourself twice a day and view these exercises as movement snacks,” he says. They are also a nice mini arm and back workout.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Practice Your Sitting

Sometimes, bringing awareness of how you typically sit, stand, and move throughout the day can be very powerful. Keep in mind: There’s no such thing as “perfect posture” or a right or wrong way to hold your body. Instead of overly focusing on how you sit or stand, Hinge Health physical therapists recommend that you move around and shift positions frequently throughout the day.

“I often have people try a quick experiment where I have them slouch forward as they sit and try to raise their arm up towards the ceiling,” says Dr. Goostree. “Then I have them sit up nice and tall and do the same thing. When they see that they’re able to raise their arm so much higher, it sometimes motivates them to either sit up straighter as they work, or simply change how they typically sit for most of their day.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Athwal, G. S. & Wiater, J. M. (2021, March). Arthritis of the Shoulder. Ortho Info — American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-shoulder

2. Rotator Cuff and Shoulder Conditioning Program. (2022, June). Ortho Info — American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/recovery/rotator-cuff-and-shoulder-conditioning-program/

3. Trapezius Muscle. (2021, June 3). Cleveland Clinic. https://my.clevelandclinic.org/health/body/21563-trapezius-muscle

4. Pieters, L., Lewis, J., Kuppens, K., Jochems, J., Bruijstens, T., Joossens, L., & Struyf, F. (2020). An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain. Journal of Orthopaedic & Sports Physical Therapy, 50(3), 131–141. doi:10.2519/jospt.2020.8498

5. Simons, S. M. & Roberts, M. (2021, April 15). Patient Education: Rotator Cuff Tendonitis and Tear (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/rotator-cuff-tendinitis-and-tear-beyond-the-basics

6. Dixon, J. B., Kruse, D. & Simons, S. M. (2022, May 10). Shoulder Impingement (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/shoulder-impingement-syndrome-beyond-the-basics#:~:text=The%20main%20shoulder%20impingement%20syndrome,lies%20on%20the%20affected%20shoulder.

7. Prestgaard, T. A. (2021, June 18). Frozen Shoulder (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/frozen-shoulder-beyond-the-basics

8. Sarasua, S. M., Floyd, S., Bridges, W. C., & Pill, S. G. (2021). The epidemiology and etiology of adhesive capsulitis in the U.S. Medicare population. BMC Musculoskeletal Disorders, 22(1). doi:10.1186/s12891-021-04704-9