Are the longer Spring days getting you back on the tennis court or into your garden? Sometimes an unwanted side effect of increased physical activity is lingering shoulder and arm pain. Shoulder pain is one of the most common reasons people seek the advice of a physician or occupational or physical therapist. The type and intensity of symptoms should indicate when to seek medical attention.  

Rotator cuff tears, shoulder tendonitis, tennis elbow and hand pain are daily conversations for occupational and physical therapists. A common topic of these conversations is determining when it’s appropriate to ask for help from a doctor or therapist. I always take a deep breath when a client says, “I’ve had shoulder pain off and on for the last nine months. I didn’t know if I should see my doctor or not.” Typically, the longer you have pain the longer it takes to fix its cause. When in doubt, get medical advice.

The shoulder is the most mobile, and complicated, joint in the body. There are over 16 major muscles, and several smaller supportive muscles, that attach to the shoulder blade. The bones of the shoulder joint include the scapula, clavicle and humerus (arm bone). Its motion and strength allows us to throw a ball to our dog at the park and push a baby stroller up hills. Unfortunately, this beautiful joint is also susceptible to injury due to trauma, poor posture, repetitive strain and general wear and tear from aging.

It can be helpful to divide arm and shoulder discomfort into four categories: emergency, get attention now, schedule an appointment, and wait it out.

If you or anyone you know is having shoulder pain that is accompanied by difficulty breathing or a sense of tightness in the chest, call an ambulance (911) immediately. These symptoms may indicate a heart attack and demands immediate attention. Ignoring these symptoms may result in death.

A sudden loss of motion or intense pain in the shoulder or arm from a fall may indicate a broken bone or torn tendon. Getting into an urgent care or emergency room promptly is the goal here. The rotator cuff and bones of the shoulder are all at risk for injury in a traumatic event. Diagnosing a torn tendon or broken bone needs to be determined by a physician, often using an x-ray or MRI.

Many clients seen in occupational and physical therapy clinics fall into the “schedule an appointment” category. Sleep disturbances are common with injuries to tendons of the shoulder. The pain may wake you up at night or you may feel shoulder pain upon waking. Symptoms during sleep lasting more than a week should lead to a phone call to make an appointment.

Performing the daily demands of caring for your children and home can be limited by arm pain. A sharp pinching sensation in the shoulder when you reach across the body can indicate pinching of the tendons of the rotator cuff. This can also occur when reaching for a seatbelt or into the back seat of a car. When a tendon is pinched, there is often a soreness that runs down the upper part of the arm. Occupational and physical therapists can determine the tendons involved with these motions and provide manual treatment and corrective exercise to treat it.

Progressive arm stiffness, often with discomfort, will limit the ability to reach overhead shelves and move items out to the side. If the arm has a gradual feeling of stiffness lasting three to four weeks it would be appropriate to make an appointment with a medical professional.

The symptoms above are typical for people who have some type of muscle, tendon or joint inflammation in the shoulder. Conditions like these are almost always correctable with conservative (nonsurgical) care. In fact, research has shown that functional outcomes after a mild to moderate rotator cuff tear are the same for both surgery and physical rehabilitation.

If you have what you would consider mild and infrequent shoulder or arm pain, the best approach might be to treat it yourself with some TLC. Over-the-counter pain relievers, rest and an ice pack used several times a day can often resolve the aches and pains of mild strain. If the injury is mild enough the discomfort should resolve within 1-2 weeks. If this approach isn’t successful after two weeks, it’s time to call a medical professional. Spring is for sun and fun, not aches and pains.  


Aaron Shaw is an Occupational Therapist and Founder of MoveMend. He can be reached at 206-641-7733 or www.MoveMend.info