I’ve helped a ton of people recover from shoulder pain. Even those who thought they had tried everything. Including surgery! Here is how I do it...
Shoulder pain can be one of the most nagging and unrelenting types of problems you may ever have to deal with. It can go on for years if not properly addressed.
One of the biggest issues with shoulder pain is that it can seriously interrupt your productivity. You may even feel like you’re having to go through life with only one arm. This could have a negative impact on all areas of your life. Shoulder pain can interrupt your ability to spend quality time with your family or staying involved in your favorite sport.
Not only this, but it can throw a wrench in the simple and everyday tasks you normally take for granted. Putting a shirt on or off, reaching into the back seat of your car, or taking something out of an upper cabinet. Even stuff as simple as trying to brush your teeth in the morning!
It doesn’t stop there -- having shoulder pain can also lead to mental distress like anxiety or depression.
Not being able to have fun doing those activities that you like to do -- or even the simple everyday tasks -- can make you feel depressed. Sometimes the anticipation about doing those activities can in itself cause you pain or apprehension and leave you feeling all sorts of anxiety or depressed feelings..
Shoulder issues can happen to everyone. You’re not alone. Here are some stats:
All these stats aside. Having shoulder pain is something you CAN recover from!
You’ll just need to use the right approach, of course.
We won’t just stop right here. I’m going to get into the weeds about what a proper shoulder recovery program will look like. You can use this info to beat the shoulder pain you’re dealing with and regain control of your life!
If done correctly, you’ll be even better than before you had shoulder pain!
These are the KEY FACTORS to recover from shoulder pain:
There’s more to it, and we’ll be getting into the details. But the majority of shoulder cases can be easily addressed by paying close attention to the key factors listed above.
You’ll want help from a competent licensed professional to help you along the way. I’ll make sure you know how to choose the right healthcare professional -- and the kinds of questions you should be asked.
All of these key factors should be addressed in a thorough and well thought out clinical assessment. Make sure the professional you reach out to for help addresses each one of these key factors. Feel free to even ask them if they will. If these factors are not a part of your plan then you are likely in the wrong place!
Let’s go ahead and get right into it!
Yes, this is an absolute must!
I can’t begin to tell you how many people have come to me after suffering for months to years and have spent buckets of money a myriad of different professionals. They all use the same general approach to shoulder pain and many even use one very similar to what I would do for a shoulder injury.
But there’s just one problem… a MAJOR problem!
Their pain was originating from a problem in their neck and not in their shoulder.
No matter how effective the approach to shoulder pain, if you’re shooting at the wrong target you’ll always miss!
The thing is, the neck contains the spinal cord and a bunch of little nerves that come out the side of it. Even if you don’t have neck pain, those nerves can become upset and result in pain anywhere from your neck down to your hand. Due to your anatomy, this pain often occurs in the shoulder.
Ruling out the neck as the cause of shoulder pain is not hard. It just needs to be done. In many cases, it will be obvious that the pain is not originating from the neck. But, if your pain was not the result of a single incident and came on gradually, or you didn’t do anything excessive with your shoulder that you can think of which may have led to your pain...
Your doc MUST make sure that it isn’t coming from your neck or nerves!
Here are a couple of signs that your shoulder pain may be coming from your neck:
Having this knowledge will greatly change your treatment plan and can fast track your recovery. So make sure your doc takes the adequate time necessary to hear you out. You don’t want them shooting at the wrong target!
What are the most reliable movements or positions that you do which reliably cause you pain? This may seem straight forward but it can often be overlooked!
Answers that I often hear are…
“Every time I raise my arm like this *OUCH* it hurts like a son of a gun!”
“I’m normally okay but when I play volleyball and jump to hit I just can’t because of the pain.”
“It doesn’t bother me unless I sleep on my right side. If I do that I wake up in a world of hurt!”
This is an excellent start! These movements and positions that are most to you should be at the first priority of addressing in your plan. But you’ll want to go even further.
You’ll want to categorize the types of specific movements or positions that flare things up. The keyword here is getting SPECIFIC. The better you can identify these specific movements or positions the better your plan will be. And the faster you will RECOVER!
One of the reasons you’ll need to identify these is so you temporarily avoid doing those specific movements so your shoulder has a chance to heal and desensitize.
Pain is your body’s alarm system. Pain tells you that something is wrong so you can correct the problem or learn to avoid an issue that may cause you trouble in the future.
When you repeatedly do movements or sink into positions that cause distress, the alarm will go off constantly. Because of this, the alarm can become recalibrated!
It gets too sensitive -- your body thinks it needs to be on high alert. Soon everything you do with your shoulder will ring the alarm even if it isn’t in harm's way!
To avoid this and help your pain calm down, you’ll want to temporarily avoid the movements that are causing the alarm to sound. When your body experiences less of that pain, you’ll be interrupting the pain cycle. This will cause the alarm will naturally go back to its natural setting. And will help you recover much faster.
Figuring out what movements or positions cause you pain helps you make easy modifications so you can go about your life while experiencing less pain. This is only temporary. But it’ll allow your body to recover and you’ll be a lot happier along the way.
You also need to know what movements do NOT cause pain. This is just as important as identifying the painful movements. Maybe even more important!
The problem is when you have shoulder pain it can place limits on what you can do.
You’ll feel like you can’t live a normal life. You may not want to do much of anything out of fear it might cause pain.
You’ll need to figure out what movements do not cause pain so you can get on with your life. This process involves getting specific about your movements again so you’re aware of what movements are safe.
This will give you the freedom to do your everyday tasks again by identifying simple pain-free modifications. And when you can do that, you’ll be helping to restore confidence in your shoulder again. This will also help to reduce the alarm!
Not only will this help you do everyday tasks but this process can also help keep you active! Nobody likes to be on the sidelines. But by being specific about this process and smart about the modifications you may able to get back in the game as well!
If your doc isn’t working hard to find ways that you CAN move in along with the ways that are painful, you’ll be missing out.
Having a clear understanding of both of these things helps to take the mystery out of your shoulder pain. Relieving much of the anxiety and depression that comes along with it, allowing you to recover faster, so you can move on with your life!
One of the best ways to help you find more pain-free movement is to open up your movement options in other areas of your body.
When dealing with shoulder pain, a lot of times this can be achieved by gaining more mobility in your upper back. Simple movements that enhance your mobility in this area can take a large burden off of your shoulder and provide you with the relief you’re looking for.
It can also make you a better athlete!
Your clinician should be able to help you find the best movement options for your specific situation. This is another reason why a proper clinical movement assessment is important for your recovery process!
Your provider should help you figure out simple and effective movements that can reliably reduce your pain. These don’t have to be elaborate. They just have to work!
The thing you’ll want to focus on are movements that you can do on your own!
Why is that? Because you need to be able to reliably reduce your pain every day multiple times a day to help reduce that awful pain cycle we discussed earlier. This is MUCH better than only getting relief when you see someone for help.
Plus, wouldn’t you want to have control over your pain? And be able to put a stop to it whenever you’d like? Or at least ease it up a bit so you don’t have to feel it nagging at you throughout the day?
A good doc will guide you through a process that identifies reliable ways for you to get this done. As I said, they should be SIMPLE. Because the easier they are for you to do then the more likely you will stay consistent!
Speaking of which…
If there is one thing I cannot stress enough when it comes to recovery… it’s Consistency!
A couple of simple pain relieving exercises or movements throughout the day are way better than 1 long session only a few times per week.
Try not to overcomplicate things! Just figure out what makes you feel better. Simplicity is always best. That way you can quickly find relief without feeling like you’re an acrobat!
You want consistent “feel-good” inputs that all day long. This way you pain alarm system is being reset back to normal. And you’ll feel better, faster!
Stay consistent and you’ll be well on your way to victory!
When you first read that you may have been thinking…
“How am I supposed to stay active when I’ve got this nagging shoulder?”
Let me explain.
You’ve identified what movements flare things up.
You’ve identified what movements are safe.
You have ways to make yourself feel better all on your own.
Using this information you will want to figure out how you can continue to do the activities you love. This can be playing with your kids, jiu jitsu, surfing, CrossFit, and anything else which is an important part of your life.
Figuring out a plan to keep you engaged and active should be a priority. Your doc will work to make this happen so you can continue to enjoy your life.
This will likely include some modifications to keep the recovery process coming along. But better to modify and stay in the game than to sit on the sidelines!
You may notice that having to modify things will only make you better in the long run!
I have had many patients that had to work on existing weaknesses in their sport due to their shoulder pain. This allowed them to recover but also enhanced areas they often neglected. As a result, they were way better than they were before this process!
Which brings us to another important part...
Your plan should include a strategy to not only get you out of pain but to make your shoulder and body more resilient so you don’t have to deal with more shoulder pain in the future. One of the best ways to do this is to GET STRONGER!
No, this doesn’t mean if you don’t work out that you should be expected to dive right into explosive barbell training.
Your doc should help you devise a plan that fits your specific needs and the goals you have. This program should meet you where you are currently at and help you to progress in a safe manner.
Again, this plan should be as simple as possible to serve the goals that you have for yourself. Overcomplicating things will only make it harder to stick to and harder to stay consistent.
This may not include any sort of weights at all. You may be better off with a bodyweight program and that will be perfect for where you are at. On the other hand, you may be perfectly capable of continuing to go BEAST MODE in a safe manner without having to worry about making your shoulder worse.
In either case, it should be challenging. If you don’t challenge your body it will not grow and adapt to be more resilient. You do not need to finish in a pool of sweat and soreness! You just need to make sure you have to put in an adequate effort.
This will include a complete medical history, clinical examination, and movement assessment performed by a licensed healthcare professional.
There are a lot of smart and caring people out there that can help others recover from pain. These include trainers, strength coaches, and massage therapists. Some movement practitioners like yoga and Pilates instructors do great work as well.
They all have their place in helping someone recover from shoulder pain but they are not trained to perform a clinical assessment! It's simply not in their wheelhouse. If they happen to miss something, it could be disastrous and make things much worse.
Ensure you are examined by a licensed healthcare professional. It is not worth the risk to do otherwise!
A ‘history’ is the story behind your shoulder issue.
This will consist of you explaining what you are dealing with and followed up by questions from your doctor. It will be a major part that will guide your care, the clinical exam, and your movement assessment.
This is the entire story about your pain. All of the things that led up to and currently surround your problem. This helps you get a complete understanding to then form your plan.
This is just as important as the rest of the process! Maybe even more important.
Your doc should take plenty of time to get to know your story and understand everything going on. They should take the necessary time to listen to you!
If they don’t take the time to do this or if you feel like they’re rushing it, you’re probably in the wrong place.
Here are some of the questions and follow-up questions that they should ask you:
How is this shoulder pain interfering with your life? What can you not do now that you could do before without pain?
This question is very important to help guide your plan! This includes everyday activities -- getting ready in the morning, driving, your training or exercise routine. How is this shoulder pain getting in your way?
What are your short and long-term goals?
Your plan needs to revolve around your short-term and long-term goals. This is extremely important! In the short-term, your goal could just be to get out of pain.
Your long-term goal could be to work to never have to suffer neck pain again -- and not have to worry about neck pain interfering with your life.
Here’s a real-life example of short-term and long-term plans:
You have an important event coming up. It’s a jiu jitsu competition that you need to train hard for.
Your long-term goal is to get the gold medal. But your short-term goal is to be able to consistently train 5 days a week.
You can still accomplish both of these with a proper plan!
The process of getting a proper history takes time.
In my office, this usually takes 20 to 30 minutes. I need to completely understand your story in order to help you the best I can. Following your history, a clinical examination and assessment is probably going to be another 20 minutes or so.
The provider you're working with needs to spend the right amount of time listening to your story. They should be asking you a ton of questions.
In my opinion, you’re not getting the care you deserve if you’re being rushed through either part of this process.
A major component of getting out of shoulder pain is finding the right healthcare provider. This person will have the ability to help guide you through this whole process.
Here’s what to look for!
A quality healthcare provider...
Spends plenty of time with you.
As we discussed above, there are a lot of questions that need to be asked. A 5-minute or 10-minute appointment will not cut it. There’s no way they’ll be able to give you the care you deserve.
There’s simply no way they can develop a specific plan for you in that short amount of time. I wouldn’t recommend any healthcare provider that limits their visits to 5-10 minutes. RUN!
Performs physical tests
A thorough clinical assessment must involve physical tests. These can help identify what is relevant to your situation and rules out what is not. This also takes time, because it’s important that nothing is missed!
Focuses on your concerns and priorities.
What matters most to you is what matters most of all!
This needs to be a primary concern of your healthcare provider. Your concerns and priorities will determine your goals. Someone that isn’t listening won’t create a plan around your needs.
Lets you be independent.
Good healthcare providers always figure out what you can do to help yourself. They won’t keep you relying on them forever to get out of pain.
Doesn’t rely on gadgets
Your treatment plan should not revolve around gizmos and gadgets. They can help of course, but shouldn't be the meat and potatoes of your recovery.
The person you need is going to prioritize an active approach and put you in charge of your recovery.
Maintains focus on your personal goals
They’ll constantly focus on your personal goals and revisit them to make sure you’re on track.
Finds ways to keep you moving
They will get you moving! In ways without pain of course. Your ability to move will be a priority.
Continuously updates the plan as you progress
Things always change. And your plan will likely change as you move forward. Your doc will be prepared for that and make sure you are too.
Feel free take these questions and ask a prospective healthcare provider, “I’m looking for someone that does this...Are you that person?”
If they can't say “Yes” -- I’d suggest you look for somebody else!
The road to recovery can be a winding road.
There's going to be ups and downs, twists and turns. As you avoid painful movements and start to incorporate them back into your life, you may experience some minor flare-ups. That's normal!
Stick with the plan -- change it as necessary -- and you'll keep the good times rollin’! This isn’t something that you should have to suffer from for the rest of your life.
Typically shoulder pain only hangs around for a week or two. But I've seen some that's lasted months, and unfortunately years. I’ve even seen people that have been living with shoulder pain for over 10+ years! And I’ve helped them regain control of their life.
You don’t have to live like that!
I am usually able to get people out of pain and discharged in 4 to 6 visits. For some people, even one visit is enough!
And they’re not just out of pain but they have an education and understanding that empowers them to keep it from happening again. If it does come back, they know how to get out of it all by themselves.
Many times I’ve seen shoulder pain turn into a launching pad for improving yourself -- in all sorts of ways.
Overcoming shoulder pain can move you toward training smarter, more consistently, better productivity, and making positive decisions about the future. Not just feeling better, or athletic performance -- but in many areas of life!
Use the information we’ve covered to find relief in the short-term. Then build a long-term plan to keep you on track -- and doing what you love.
Thank you for reading! I hope you’re able to take control of your shoulder pain better moving forward.
And if you need help with this process -- give me a call. I’m ready to get you back in action!
***The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.***
Dr. Ben Ramos
DC, MS, CSCS, Founder of FlowForce Rehab
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