Shoulder Pain: Causes, Treatment and Physiotherapy Exercises
Most shoulder pain in adults involves the rotator cuff tendons and how the shoulder blade moves. Progressive loading of the rotator cuff, combined with shoulder blade strength work, is more effective than rest for the majority of cases.
Shoulders are demanding joints: enormous mobility supported mostly by muscle. When the load exceeds what those muscles are prepared for, pain follows, usually on reaching, lifting or sleeping on that side.
Common causes
Rotator cuff related shoulder pain is by far the most common, often described as impingement. Frozen shoulder produces marked stiffness in all directions and follows a longer course. Shoulder pain can also be referred from the neck, which is why the neck is assessed alongside the shoulder.
What treatment involves
Treatment normally includes graded loading of the rotator cuff, work on shoulder blade control and mid back mobility, and advice on modifying aggravating activities such as overhead work or bench pressing. Manual therapy and dry needling may reduce symptoms in the short term.
Realistic timelines
Rotator cuff related pain often improves substantially in six to twelve weeks with consistent loading. Frozen shoulder is slower and can take many months, although physiotherapy may help maintain movement and manage pain along the way.
Exercise programme
Work within a comfortable range. Mild discomfort is common, sharp or increasing pain is not.
1. External Rotation With a Band
BeginnerStarting position: Standing with elbow at your side bent to ninety degrees, band anchored at waist height.
- 1Keep your elbow tucked in against your body.
- 2Rotate your forearm outwards away from your stomach.
- 3Return slowly under control.
Suitable for: Rotator cuff related shoulder pain.
Use a light band. Keep pain at or below three out of ten.
2. Scaption Raise
IntermediateStarting position: Standing with light weights or no weight, arms at your sides.
- 1Raise your arms at about forty five degrees between front and side.
- 2Lift only to a comfortable height.
- 3Lower slowly.
Suitable for: Restoring pain free overhead reach.
Stop at the height where pain begins rather than pushing through.
3. Wall Slide
BeginnerStarting position: Forearms on a wall at shoulder height.
- 1Slide your forearms up the wall.
- 2Allow your shoulder blades to rotate naturally.
- 3Slide back down with control.
Suitable for: Improving shoulder blade movement with low load.
Avoid shrugging heavily into the neck.
When to stop and get assessed
- Sharp catching pain during the movement.
- Pain that keeps you awake more than usual that night.
- Sudden weakness or inability to lift the arm.
When to see a physiotherapist
See a physiotherapist if shoulder pain lasts more than three weeks, disturbs sleep, follows a fall, or is limiting work and sport.
Related physiotherapy services
Frequently asked questions
Should I rest a painful shoulder?+
Complete rest usually stiffens the shoulder. Modified activity with graded loading is generally more effective.
What is shoulder impingement?+
It is a descriptive term for pain on reaching overhead, most often related to rotator cuff tendon irritation and load.
How long does frozen shoulder last?+
It typically runs a prolonged course over many months. Physiotherapy focuses on maintaining movement and managing pain.
Can neck problems cause shoulder pain?+
Yes. Neck referred pain is common, which is why both areas are examined during assessment.
Medical disclaimer: this article is general education and does not replace a personal assessment. If your pain is severe, worsening, or accompanied by numbness, weakness or loss of bladder or bowel control, seek care promptly.
Book with N S Physiotherapy
In clinic in Eco Park, Centurion, or home visits across Centurion and Midrand.
Related articles
- Neck PainGuideNeck Pain: Causes, Treatment and Physiotherapy Exercises
Most neck pain is mechanical and settles within a few weeks with gentle mobility, strengthening of the deep neck and shoulder blade muscles, and better daily positioning. Pain with arm symptoms, dizziness or after trauma should be assessed sooner.
12 Aug 2026Read article - PostureExercises for Forward Head Posture
Forward head posture is common and is not automatically painful. Rather than trying to hold a perfect position, build endurance in the deep neck muscles, improve upper back mobility and change position often.
12 Aug 2026Read article - Physiotherapy ExercisesExercises for Neck Pain and Tight Neck Muscles
A useful daily routine combines gentle range of movement, one or two stretches for the upper trapezius and levator scapulae, and endurance work such as chin nods. Five to ten minutes once or twice a day is usually enough to start.
12 Aug 2026Read article