How To Fix Shoulder Pain & Stiffness

What if I told you that your shoulder problem isn't about strength, but stiffness?

Most rehab focuses on strengthening muscles like the rotator cuff, yet strength is rarely the root cause of the pain. Your rotator cuff and other muscles need to be in the right position to work properly. What’s often overlooked is how stiffness in your ribcage impacts shoulder function.

Your shoulders attach to the shoulder blade, which sits on your ribcage, connected to your spine. Stiffness in these areas pulls your shoulder out of position, causing discomfort, weakness, and limited movement.

If your ribcage can’t expand when you breathe, muscles like the pecs, lats, and upper traps become chronically tight.

The real magic happens when you loosen these stiff areas and get the ribcage moving to relieve shoulder pressure.

Ready for a quick test? Stand with your back against a wall and try to raise your arms overhead without arching your back:

Struggle bus? That's a red flag for stiffness, not just in the shoulder, but the ribcage as well.

Don't worry, we're about to show you how to fix your shoulders with a simple, effective approach so you can get back to doing what you love, pain-free.

Let’s dive into our treatment model.

The Treatment Model

Our treatment model for fixing shoulder pain is based on three simple concepts:

1. Relieve Pain: Gentle movements and breathing drills to open up your ribcage, decompress your shoulders, and turn down the volume on your pain signals.

2. Restore Function: Mobility exercises to make your shoulders and ribcage work like a well-oiled machine.

3. Prevent Injury: Strengthen your shoulder to handle all the crazy positions it can get into, so your pain doesn’t keep coming back.

Here's the thing: we’re not after a quick fix. There’s plenty of those out there, and if that’s what you’re after, you’re in the wrong place.

Your shoulder didn't get messed up overnight, and it won't heal overnight either. Expect to work on these for a minimum of 4 to 6 weeks for true tissue healing, but the good news is most people feel pain-free much sooner.

Pain relief is just the first step to lasting improvement. We want you pain-free AND fully functional, and restoring full function takes time.

Relieve Pain

This is all about opening up the ribcage (and shoulders), turning off the pain signals, and getting fast relief. To start, we're going to use a one-two punch of breathing drills and walking. Yep - walking.

Daily Movement Target

Here's the deal: pain often leads to less movement, which is exactly what we don't want. One of the ways we promote healing is to get more non-exercise movement in–AKA walking.

So, we're aiming for 8k to 10k steps per day. This isn't just a FitBit flex - it's promoting tissue decongestion, boosting blood flow, and even improving your sleep quality.

Breathwork

Breathing drills are a super simple (and effective) way to decompress the ribcage, open up the shoulders, and relieve pain quickly.

One of my favorites is the Standing Lat Stretch. While it looks like a lat stretch, the primary goal is to open up the ribcage on that side. Here's how to do it:

Do this for 2-3 rounds of 5-10 breaths per side, 2-3 times per day. It's like a reset button for your shoulders.

Rx:

• Standing Lat Stretch: 2-3 rounds of 5-10 breaths per side, 2-3 times a day.

• Daily Movement Target: Aim for 8k to 10k steps per day.

• Bonus: Aim for 7-8 hours of sleep per night to reduce inflammation and promote healing.

Restore Function

Time to get those shoulders moving again. Remember, shoulder pain is often a result of stiffness, not weakness. So we need to restore normal function to your shoulder and everything around it. These exercises will help.

Shoulder Extension

This shoulder opener helps decompress the front of the ribcage and opens up the pecs. Same breathing strategy as above.

Quick tip: let the band pull your shoulder down and back, and aim to find a moderate stretch on the front of your shoulder and pec. You may need to noodle around a bit, but once you find a good stretch, just hang out and breathe!

Rx:

• 1-2 rounds of 5-10 breaths per side, 2-3x per day.

Alternating Down Dog Toe Taps

To ‘own’ the new range of motion, it’s important to get everything moving under load. This exercise gets the shoulder blades moving, improves upper back flexibility, and builds strength throughout the entire shoulder girdle.

Rx:

• 1-2 rounds of 6-12 reps per side, 2-3x per day, after your mobility drills.

• While doing these, keep your teeth together, tongue on the roof of your mouth and maintain nasal only breathing throughout!

Prevent Injury

Now that we've turned down the pain signals and got things moving, let's build some strength and resilience to keep those shoulders happy long-term.

Enter the Turkish Get-Up. This exercise is like a Swiss Army knife for your shoulders. It loads the shoulder and takes it through multiple positions, building strength every step of the way, along with mobility in your shoulder, ribcage and spine.

Do these as a regular component of your training and increase weight as you are able.

Rx:

• Frequency: Perform 3-4 times a week

• Sets/Reps: 3-5 sets of 1 rep per side

• Integration: Perform as a standalone workout or a warm-up before other sessions

• Progression: Increase the weight as you get stronger

TL;DR Your Shoulder Savior

We've covered a lot of ground, so here's the TL;DR version:

1. Your shoulder problem is likely more about stiffness than strength.

2. We're following a 3-step plan: Relieve Pain, Restore Function, Prevent Injury.

3. Relieve Pain: aim for 8-10k steps daily and do the Standing Lat Stretch.

4. Restore Function: Banded Shoulder Extension Opener and Down Dog Toe Taps.

5. Build strength & resilience with the Turkish Get-Up.

My goal was to teach you about the causes of shoulder pain and show you a simple approach to healing. If your shoulder hurts and you're looking for a long-term solution, our full approach expands on everything in this article and personalizes it for exactly what you need.

If you need more guidance, this is exactly what we help people with every single day at Athletes' Potential Columbus.

If you’re in the Columbus, OH area: click here to schedule a free phone consult with my team. We’ll ask you a few questions and see if we’re a good fit to help.

If you're outside of Columbus, OH: that's exactly why I created my virtual pain & mobility coaching program. Click here to schedule a free consult with me!

Keep moving and stay awesome,

Dr. Matt Longfellow, PT, DPT, SCS, SFG-II