My arm hurts when I raise it | Total Performance Physical Therapy

My arm hurts when I raise it

June 6, 2019

If your shoulder hurts when you raise your arm, you’ve probably wondered what exactly is causing you to have this pain that is interfering with your everyday life. You may have even wandered the internet attempting to self-diagnose in the hopes that you can treat it on your own. During your search, you come across many, many potential causes.

There are so many possible reasons your arm hurts, so it’s important to get a diagnosis so that you can begin proper treatment quickly. Do you know why your shoulder hurts when you raise it? What should you do to treat it? We’ll explore all of this and more — but first, we invite you to check out this video for more information about shoulder pain, common causes, and how Total Performance Physical Therapy can help:

What Are the Most Common Causes of Shoulder Pain and Injury?

If you’ve been suffering from chronic shoulder pain when you raise your arm, you may be suffering from a potential injury. Some minor injuries can heal on their own in two weeks with rest, ice, and over-the-counter remedies. 

Some of the most common shoulder pain injuries can include:

Treating the source of your shoulder pain is important to prevent further injury.

It is important to understand why your shoulder hurts the minute it starts to hurt. Now, your shoulder pain is nothing to worry about if any of these apply to you:

This is the first time you ever felt pain in your shoulder. You just happened to reach overhead this morning and had pain. The very first day, the very first time. This could just be a weird pain that will probably go away tomorrow.

If you had surgery on your arm in the last two weeks, you’ll need to keep an eye on your pain levels to ensure that you are healing the way you are supposed to. Pain from surgery can last weeks and even months after the surgery, so if you recently had surgery on your shoulder, you may still have pain when reaching overhead. You will want to let your doctor know if this pain persists.

If you had a hard workout within the last 48 hours where you did a lot of shoulder exercises, you might be sore in the days that follow. Muscle soreness can last two days after working out, so if you recently did an arm workout within the last 48 hours, then it can be perfectly normal to have difficulty lifting overhead. If this workout was done over a week ago and you still have pain, then you need to be concerned.

If you cannot exclude yourself with one of these three things, then your shoulder pain is a reasonable cause for concern.

The first thing you need to do is find the exact cause of your shoulder pain. Finding the source and the cause of your shoulder pain will help you be able to treat it and prevent further damage to it. What could the problem actually be?

Tendinitis 

Tendinitis is an inflammation of the shoulder muscles. There are several muscles of the shoulder that could be inflamed. It is important to find out which muscles of the shoulder are inflamed.

Common signs and symptoms: Pain with reaching overhead, pain with sleeping, pain with lifting an object off the floor, and shoulder muscles that are painful to the touch.

Arthritis

With arthritis, it’s common for the early stages to be apparent on an x-ray, but in many cases, arthritis is not the cause of shoulder pain in young people.

Common signs and symptoms: Constant pain that is not made better or worse with activity. Pain that is the same upon waking and pain that is the same going to bed.

Rotator Cuff Tear

Many people jump to worrying they have a rotator cuff tear at the earliest signs of shoulder pain. If you have a rotator cuff injury, physical therapy and sometimes surgery can help. 

Common signs and symptoms: Pain that radiates into the side of the arm and pain with reaching overhead

Frozen Shoulder

A frozen shoulder is the result of something else going on in the shoulder. For some reason, whether it be tendinitis, a tear, or something else, you have limited mobility in your shoulder. This causes it to ‘freeze,’ and you are unable to move it.

Common signs and symptoms: You are unable to move your shoulder; it is literally ‘frozen.’ No matter what you do, you cannot push the shoulder any further.

Instability

Many people who have competed in sports that have an overhead component (swimming, volleyball, baseball, etc.) usually can have instability.

Common signs and symptoms: Usually, this type of condition doesn’t hurt. This type of shoulder condition leads to other shoulder problems, but this does not cause pain.

Dislocation

This is a traumatic event unless you are someone who can do this very easily. Anyone who can do this very easily knows how to deal with it.

If you feel that you have sustained a traumatic shoulder injury that has caused it to come out of its socket, you need to seek medical attention ASAP.

Impingement

This is a common cause of rotator cuff tears, and people frequently make the mistake of ignoring the pain, hoping it will go away on its own. While you are ignoring it or taking Advil to relieve the symptoms, it is sawing away at your rotator cuff, which can result in more time and money lost in the long run.

If you have primary impingement, there is a space (below bone on top and the arm bone) that becomes progressively occupied by bone spur formation on the undersurface of the acromion (the bone on top). This bone spurs form from either an anatomical variation in which the acromion ‘hooks’ into the subacromial space or through degeneration in which repetitive use causes microtrauma to the undersurface of the acromion, and the body responds by forming bone.

This form of impingement typically occurs in older adults or people with anatomical differences in their acromion and is corrected surgically.

Secondary impingement is more common and typically occurs in younger people aged 25-40. The reason the structures in the subacromial space are pinched is not due to bone occupying the already narrow space, but due to instability where the humerus cannot be held correctly in place and the humerus migrates up into the space, causing impingement.

Secondary impingement, where the humerus is not held correctly in the joint, can occur for a few reasons. The rotator cuff is composed of four small muscles that attach from your shoulder blade to your humerus function to hold the humerus in place.

When these muscles are overworked, say from repetitive overhead activity, or are weak, they cannot hold the humerus in place, and impingement occurs. In addition, when your shoulder blade is not positioned properly, the rotator cuff muscles are placed in sub-optimal conditions causing them to overwork and fatigue, eventually leading to impingement.

Another cause of secondary impingement that is applicable to virtually everyone is posture. If you have a slouched posture where your head is forward, shoulders are rounded, and mid-back is flexed, the shoulder blades and rotator cuff muscles are put out of place, and shoulder motion is lost. You can see this work if you try it yourself. Sit in a slouched posture and try to lift your arm overhead; now, sit up straight and try lifting your arm once again. You can see how posture affects the way that your shoulder moves just by attempting this at home. Poor posture also causes the front portion of your body to become tight and the back muscles to become stretched out and weak.

As impingement occurs, whether primary or secondary, it can lead to bigger problems down the road if it is not addressed. As the structures in the subacromial space have impinged, irritation and pain occur, leading to edema (swelling or buildup of fluid) and inflammation of the structures and the joint. The edema and inflammation, along with continued shoulder impingement, can then progress to tendinitis and degeneration of the structures. Inflammation and degeneration, along with further shoulder impingement, can lead to bone spur formation and rotator cuff tears.

What do I do once I figure out what the cause of my shoulder pain is?  

Take Advil/Aleve/Anti-Inflammatories to reduce the pain and take the edge off just to function.  

If you have taken Advil for more than two weeks, you are at risk for serious stomach complications. We all know someone who has taken Advil and Aleve for months (and it may even be you) and has had no problems. If you continue to take Advil to ‘take the edge off,’ you are putting yourself in danger of severe complications and not just with your shoulder, it is with your stomach, and the damage that happens cannot be reversed.

You’re taking Advil because you don’t have time or money or both to go to the doctor or physical therapist. You think that by taking the Advil to reduce the pain, hoping it will go away, you are saving time and money. In reality, taking Advil for more than two weeks will cost you tens of thousands of dollars more in hospital bills to treat the stomach issues, and that won’t even address the shoulder pain. And it will cost you weeks away from work as you recover from your trip to the hospital. If you have been taking Advil or any anti-inflammatories for more than two weeks consecutively, you are putting yourself at severe risk of stomach damage.

Ignore it. It will go away.

While we can’t go to the doctor for every ache and pain as we get older, otherwise, we would never leave. Waking up with aches and pains is part of everyday life when you get older. No doubt, but living in pain is not.

Two weeks is the general rule. Two weeks is the maximum amount of time you give the same pain that shows up day after day and doesn’t improve. You can no longer ignore it.

Ignoring the pain that goes on for more than two weeks is like neglecting a leak in the roof. It may be able to go on for a few days, weeks, or months with no noticeable increase in the drip, but now you have had exposure prolonged to water damage and potentially mold.  

Ignoring a shoulder problem can cost you tens of thousands of dollars. While dealing with it right away may have cost some initial investment, it would have been resolved with no surgery and no time away from any activities.

Take charge of your health.

Taking time when your shoulder starts hurting will allow you to save time and money. If you deal with the shoulder pain when it comes on, it prevents any compensation issues that would need to be dealt with. It would be a limited amount of time and money.

If you deal with shoulder pain as it comes up, you can schedule appointments as it makes sense for you, before work, after work, or during lunch. The time it will take to heal will be far less than if your shoulder pain leads to surgery and will require no time off of work.

What should I NOT do if I have shoulder pain?

Regardless if you know the cause, take a look at this video to learn more about what you should avoid if you experience shoulder pain:

What happens if the pain doesn’t go away with the at-home treatment?

You need to see a physical therapist that specializes in healing injuries. Exercises alone will not heal this. Chronic shoulder pain needs hands-on treatment.

Let’s talk about how physical therapy can be used to address the issue.

First, it is important to address one’s posture, which can be done quickly and easily in one session. With proper posture, your joints, muscles, and tendons are in a better position to function without overworking.

It is necessary to avoid shoulder movements that aggravate your shoulder pain.

It is important to strengthen the rotator cuff muscles to hold the humerus properly in place.

Strengthening the muscles that attach to the shoulder blade (trapezius, serratus anterior, rhomboids, levator scapula, and latissimus dorsi), which affect shoulder motion, is needed shoulder blade in the optimal position for the shoulder joint to achieve full motion.

A physical therapist understands that stability and control of motion are just as vital if not more so than strength.

Physical therapists can recognize any compensatory movements you may be using that contribute to the pain and introduce exercises that will increase shoulder stability.

If your capsule is too tight and causing pain, physical therapists can use various joint mobilizations to decrease the capsule’s stiffness. Shoulder strength, stability, and control of motion are critical to your recovery, along with modifying activities that aggravate your shoulder pain in the beginning phases of the inflammatory process. Addressing these issues will allow for a full, pain-free shoulder range of motion and prevent more significant problems from happening.

How should I sleep when my shoulder hurts?

Not only can shoulder pain be debilitating throughout the day, but it can make it difficult to fall — and stay — asleep. Refer to this video about the best position to sleep in when you have a shoulder injury:

Physical Therapy Exercises for Shoulder Pain

If you have persistent shoulder pain when you lift your arm, the best thing you can do for your recovery is see a doctor and start building a physical therapy routine. In some cases, chronic shoulder pain will be the result of severe injury. If that’s the case, you may need surgery. After surgery, physical therapy is the next logical step. 

You mustn’t attempt to treat your injuries without a diagnosis, but below you’ll find some helpful physical therapy exercises to try if you notice that your shoulder hurts when you raise your arm. 

If your shoulder hurts when you lift your arm, follow these tips for physical therapy exercises to improve your range of motion and lessen your pain. 

Your physical therapy can only be as good as the amount of effort you are willing to put into it, but there is a balance. Overdoing your physical therapy exercises can prolong your recovery and further limit your range of motion. Neglecting your physical therapy can have the same effect.  

It’s recommended that you start with 10 minutes of exercise a day. As your range of motion improves, and you feel less pain, you can slowly increase the time. While doing your workouts, it’s important to relax and not rush your progress. The point of physical therapy is to release tension and relieve tightness. 

Healing is not always a linear process. You may be capable of more motion one day and struggle with the same exercise the next day; it’s okay. It’s more important that you take your time and only do what is comfortable on a given day.

Check out this video for more information about exercises for shoulder pain relief:

Does Your Arm Hurt When You Raise It? Turn to Total Performance Physical Therapy

If you experience pain when you raise your arm, it may be advantageous to seek professional help. For more information about physical therapy for shoulder pain, reach out to our team or request an appointment today!