Shoulder Pain in Front: What it Means.

Shoulder Pain in Front: What it Means.

By Professional Physical Therapy

Front shoulder pain is a very common problem. It can come on gradually, over time or suddenly after an injury.  Pain in the shoulder may extend down the arm or there may be associated symptoms such as burning pain or numbness. But how do you know what’s wrong? We will look at the causes of front shoulder pain, specific symptoms associated with different conditions and treatment options to help individuals better understand and manage the pain or discomfort.

Common Causes of Front Shoulder Pain

Front shoulder pain can stem from a multitude of factors, ranging from overuse injuries to underlying medical conditions. Some common causes include:

  1. Rotator Cuff Tear or Injury: The rotator cuff comprises a group of muscles and tendons that stabilize the shoulder joint. Overuse, repetitive movements, or sudden trauma can lead to strains, tears, or inflammation in these structures, resulting in front shoulder pain.
  2. Shoulder Impingement Syndrome: This occurs when the rotator cuff tendons or bursa become pinched or compressed within the shoulder joint, often due to repetitive overhead movements or poor posture.
  3. Biceps Tendinitis: Inflammation of the bicep’s tendon, which attaches to the front of the shoulder, can lead to pain and tenderness in the area. This may result from repetitive lifting, reaching overhead or throwing repeatedly.
  4. Bursitis: Bursae are small fluid-filled sacs that cushion the bones, tendons, and muscles around the joints. When these bursae become inflamed due to repetitive motions or trauma, it can cause pain and discomfort in the front of the shoulder.
  5. Labral Tears: The labrum is a ring of cartilage that surrounds the shoulder socket. One of the less common causes is a tear in the labrum, particularly those located in the front (anterior) region, can cause pain and instability in the shoulder.
  6. Arthritis: Degenerative conditions such as osteoarthritis or inflammatory arthritis can affect the shoulder joint, leading to pain and stiffness in the front of the shoulder.
  7. Frozen Shoulder (Adhesive Capsulitis): Characterized by stiffness and pain in the shoulder joint, frozen shoulder can also present itself as front shoulder pain. It often develops gradually, limiting range of motion and causing discomfort during everyday activities.
  8. Fracture: Fractures, or breaks occur most often in the collarbone or upper arm bone. Both types of fracture may result from a fall onto an outstretched hand or a blow to the shoulder. In most cases they will cause severe pain, swelling, and bruising. Consult your doctor immediately for suspected shoulder fractures.
  9. Dislocation: Shoulder dislocations occur when the ball of the upper arm bone pops out of its socket. The arm bone may dislocate forward, backward, or downward, whether partially or completely. Dislocations may recur if the surrounding structures of the shoulder become worn down. Dislocation is typically caused by a fall or a direct blow to the shoulder. A dislocated shoulder should also receive immediate medical attention to prevent complications and facilitate proper healing.

Types of Shoulder Pain That Occurs in Front

Front shoulder pain can manifest in various ways depending on the underlying cause. Here are some specific symptoms associated with common conditions:

  1. Rotator Cuff Tear or Injury:
    • Dull, aching pain in the front of the shoulder, often worsened by overhead activities or reaching behind the back.
    • Weakness and instability in the shoulder joint.
    • May experience popping sensations during arm movement.
    • Difficulty lifting or rotating the arm.
  2. Bursitis and Arthritis:
    • Sharp or burning pain in the front of the shoulder, especially with movement.
    • Swelling and tenderness around the affected area.
    • Pain may worsen at night, interfering with sleep.
  3. Shoulder Impingement Syndrome:
    • Pain and discomfort in the front of the shoulder, particularly when you lift your arm overhead or when reaching out to the side.
    • Weakness and loss of strength in the affected shoulder.
    • Pain may radiate down the arm.
  4. Frozen Shoulder (Adhesive Capsulitis):
    • Gradual onset of shoulder stiffness, with limited range of motion in all directions.
    • Dull, aching pain that may worsen at night or with prolonged inactivity.
    • Difficulty performing daily tasks such as reaching behind the back or putting on clothing.
  5. Shoulder Fracture:
    • Severe pain, swelling and bruising.
    • Shoulder will be tender to the touch around the injury.
    • Inability to move the shoulder.
    • Bones may appear out of position, but in some cases may not result in an obvious deformity or misalignment.
  6. Dislocated Shoulder:
    • Sudden pain that may radiate down the arm or into the neck.
    • Swelling or bruising in the affected shoulder.
    • Numbness, weakness or tingling near the shoulder injury.
    • Inability to move the joint.
    • Arm may look out of place; misalignment of the shoulder is very common.

Early Intervention: Key to Effective Treatment

Early diagnosis of shoulder issues is crucial. It can lead to more effective treatment outcomes, quicker relief, and can help prevent the progression of conditions. If you’re experiencing persistent shoulder pain or discomfort, we encourage you to seek professional advice promptly.

Treatment Options

The best treatment for front shoulder pain will depend on the underlying cause but will usually involve a few initial conservative treatment options followed by Physical Therapy. Physical therapy often plays a central role to manage and reduce pain in the front shoulder effectively.

  1. Rest and Activity Modification: Giving the shoulder adequate rest and avoiding activities that aggravate the pain can help promote healing. Modification of activities to reduce overhead movements or repetitive actions may also be beneficial.
  2. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics may be prescribed to help alleviate pain and reduce inflammation associated with front shoulder pain. In some cases, corticosteroid injections may be recommended to provide temporary relief from severe pain and inflammation.
  3. Physical Therapy: A structured physical therapy program can help reduce pain, strengthen the muscles surrounding the shoulder joint, improve flexibility, and correct any underlying biomechanical issues contributing to the pain. PT plan can include:
    • Targeted Exercise Prescription: Exercises to help improve stability, mobility, and neuromuscular control, reducing pain and enhancing overall shoulder function.
    • Manual Therapy Techniques: Hands-on manual therapy techniques, such as joint mobilization, soft tissue massage and stretching are utilized to help alleviate pain, reduce inflammation, and restore joint mobility.
    • Modalities for Pain Relief: PTs may use ice or heat therapy, ultrasound, electrical stimulation, and laser therapy to provide pain relief and promote tissue healing.
    • Postural Correction and Ergonomic Education: Addressing proper posture habits and ergonomic factors is essential for long -term management and prevention of recurrence.
    • Activity Modification: Physical therapists guide patients in modifying activities or sports that exacerbate shoulder pain to prevent further injury.
    • Patient Education and Self-Management Strategies: Empowering patients with knowledge about their condition, self-management strategies and home exercises is a crucial part of therapy and recovery.

4. Surgical Intervention: In cases where conservative treatments fail to provide adequate relief, surgical intervention may be considered. Surgical procedures such as rotator cuff repair, labral repair, or shoulder decompression may be performed to address underlying structural abnormalities and alleviate front shoulder pain.

Preventing Shoulder Injuries

Shoulder problems can often be fixed without surgery, but it is best to avoid the problem in the first place. Here are some ways to prevent shoulder pain or injury.

  • Warm-up Properly: Engage in dynamic stretches and light activities that increase blood flow to the shoulder muscles before intense exercise.
  • Maintain Good Posture: Regularly check and correct your posture, especially if working at a desk for prolonged periods, to avoid unnecessary strain on your shoulders.
  • Strength Training: Incorporate exercises that strengthen the shoulder, back, and core muscles to support and stabilize the shoulder joint.
  • Limit Overhead Activities Be mindful of the frequency and intensity of overhead activities to prevent overuse injuries.
  • Simple Home Exercises: Daily exercises can help keep your shoulders healthy.
    • Pendulum Swing: Lean forward, letting one arm hang loosely. Swing the arm gently in circles and side to side.
    • Shoulder Blade Squeeze: Sit or stand with your arms by your sides. Squeeze your shoulder blades together, hold for a few seconds, and release. Repeat several times.
    • Wall Push-ups: Stand an arm’s length from a wall. Place your hands on the wall at shoulder height and perform a push-up against the wall.

Front shoulder pain can significantly impact an individual’s quality of life, affecting their ability to perform daily activities. By understanding the underlying causes and specific symptoms associated with front shoulder pain, individuals can seek timely intervention and appropriate treatment to facilitate recovery.

At Professional Physical Therapy, we understand the challenges of living with shoulder pain, and our team of skilled clinicians is dedicated to helping you achieve optimal recovery and function. Contact us at Professional Physical Therapy today.  Request an appointment to schedule a comprehensive evaluation and start your journey toward a pain-free shoulder.

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