Shoulder pain while running can show up in different regions of the shoulder muscle group, including the upper trapezius (a muscle that attaches to the neck, shoulders, spine, and base of the skull), deltoids (sides of the shoulders), or rotator cuff (muscles and tendons surrounding the shoulder joint). The sport is a “very dynamic form of exercise” that relies on many different muscle groups, including the shoulders, neck, and upper back, explains Ramon Julian M. Pesigan, M.D., assistant professor at Mount Sinai Health System and primary care and sports medicine specialist at the Samuel J. Friedman Center for the Performing Arts in New York City.
While these upper-body muscles are not the main drivers in running, they do play an important role in helping us run with good posture. And running with good posture—shoulder blades back and down, chest up, eyes forward, neck in line with your spine—maximizes the efficiency of your stride and reduces your risk of injury. For a variety of reasons, your upper body muscles—including the shoulders—can ache during a run.
Here, we dig into why you may experience shoulder pain while running, and also share expert tips for alleviating and preventing this irksome issue.
Common Causes of Shoulder Pain
The following general guidelines will help you determine which category you might fall under, but keep in mind that you’ll need to visit a professional to get a proper diagnosis. If you have any doubts, it’s worth visiting your doctor or PT.
You Recently Started Running, or You Recently Upped Your Mileage
Any time you start a new activity—or dial up the intensity of current activity—your body is going to feel the effects of that change as it works to adapt to the increased demands. Think back on your training over the past seven days. If you have started running after a long hiatus, or suddenly bumped up your mileage, all the muscles involved in running, including your shoulders, are going to take on extra stress and pain at first, says Dean Somerset, C.S.C.S., kinesiologist, and exercise physiologist.
How to treat it: Ice sore areas for 20 minutes, wait one to two hours, and then ice again if needed, advises certified exercise physiologist DeAnne Davis Brooks, Ed.D., C.S.C.S., an associate professor in the department of kinesiology at the University of North Carolina Greensboro and USATF Level 1 track coach. Stick with your exercise routine, if possible, but if your shoulder soreness is too acute for that, dial back the intensity until your aches subside, which should happen in a week or less. If soreness doesn’t get better in a week, visit an athletic trainer to make sure you’re not dealing with an injury, says Brooks.
How to prevent it: Ramp up your training gradually to avoid excessively stressing your shoulders (and the rest of your body).
You’re Holding Too Much Tension in Your Upper Body
When runners get tired or try to push the pace, they may inadvertently tense their neck muscles and hike up their shoulders, explains Rajwinder Singh Deu, M.D., assistant professor of orthopedic surgery at the Johns Hopkins School of Medicine. Other runners may consistently hold extra tension in their upper body as they stride, says Somerset.
In both scenarios, this excess tension can fatigue and tighten the shoulder muscles and lead to shoulder pain. If your shoulder pain is accompanied by jaw and neck pain, that could be a sign you are holding too much tension in your upper body as you run, says Somerset. Another indication, Somerset adds, is if you feel like you can’t move your shoulders while running.
How to treat it: Ice sore areas (start with 20 minutes, wait one to two hours, and then ice again if needed), and if the achiness is severe, reduce the intensity of your running until it subsides. Otherwise, keep training as usual and follow the below tips to prevent the issue from returning.
How to prevent it: As you stride, stay mindful of where you hold tension, says Somerset. If you feel the pain creeping into your shoulders, focus on the muscle (or muscles) that hurts, breathe through the discomfort, and then try to relax the area, suggests Brooks.
You Have Poor Posture
All of the experts agreed that poor posture—i.e. rounding your shoulders, hiking your shoulders up toward your ears, and/or leaning your head forward—is a big cause of shoulder pain while running. This improper positioning can cause your upper trapezius and levator scapulae (a neck muscle that connects at the very top of the spine) to take on too much work, explains Brando Lakes, D.P.T., a physical therapist with Orthology in New York City. And when these muscles become overused, they’ll start to ache. Sometimes, poor posture can lead to non-specific pain that radiates, says Lamontagne.
How to treat it: Again, ice sore areas as needed and dial back your training as appropriate. To truly treat the issue, however, you’ll need to ID—and then correct—your poor posture. You can do the former by filming yourself, or, if you’re passing a storefront, take a glance at your reflection, says Lamontagne. Form errors can be tricky to spot though, so you may also want to get evaluated by a running coach or physical therapist to learn exactly what you’re doing wrong—and how to fix it.
How to prevent it: Stay mindful of your posture as you run. Think Shoulder blades back and down, chest up, eyes forward, neck in line with your spine. If you feel yourself slipping into the poor posture as you run, drop your hands and shake them out, or do a quick shoulder roll forward and backward suggests Brooks.
This mini stretch break can help you refocus your attention on maintaining good form while also providing a quick reprieve for aching muscles. It’s also important to practice good posture in your day-to-day life, especially now, as many of us spend our days hunched over couch desks at home. Taking the time to set up an ergonomic workspace can make a “big difference,” says Brooks.
Shoulder Impingement (Subacromial Pain Syndrome)
What it is: The supraspinatus muscle and tendon, which form part of the rotator cuff (a group of muscles that move and stabilize the shoulder), slide through a narrow channel in the shoulder called the subacromial space. When shoulders are overworked and aggravated, this space can shrink and eventually pinch the tendon.
Symptoms include discomfort (anything from a dull ache to a sharp pain) in the front or side of the shoulder. Pain typically increases when you lie on your side, raise your arm, or reach across your body or behind your back.
One common test for this injury is called the painful arc: draw a 180-degree arc with your fingertips by lifting your arm straight out to the side, starting with your arm resting at your side and lifting until your arm is pointed directly upwards next to your ear. If you feel no pain at first, but then do experience pain as your arm moves between 60 and 120 degrees (when the subacromial space is the smallest), and then no pain again toward the top of the arc, you could have this injury.
Why you get it: Overuse by repetitively moving the shoulder into the end ranges of its mobility or stressful positions is a common mechanism of injury. These types of movement patterns include overhead reaching, chicken-winging while climbing (sticking your elbows out and up—a common mistake among beginners), or holding your bike handlebars with bent, raised elbows (common among mountain bikers).
Poor posture is also a factor. When we slouch, the chest caves in, causing the pectoralis muscles to tighten. The thoracic spine flexes forward, stretching the upper-back muscles, and the shoulders round forward, which decreases the subacromial space. While this won’t necessarily cause the injury, it can make it worse and prolong the recovery process.
A Rotator-Cuff Strain or Tear
What it is: The rotator cuff is made up of four muscles, which connect the upper arm bone to the shoulder blade, control shoulder motion, and provide dynamic stability. These can be strained or torn, like any muscle, across a spectrum of severity, from a mild stretch to a partial tear to a complete rupture.
With this injury, pain is typically located in the side of the shoulder and can radiate toward the back of the shoulder, whereas with subacromial pain syndrome, the pain usually feels closer to the front. Pain often increases when you lift objects out to the side. To test yourself at home, stand with your back to a wall, with your arm at your side and that elbow bent to 90 degrees. Gently press the back of your forearm into the wall, which will engage a rotator-cuff muscle to externally rotate the arm. If this motion generates more discomfort or feels significantly weaker on your bad side compared to your other arm, it’s a sign you could have this injury.
Why you get it: Overuse is often the culprit for rotator-cuff injuries. Poor technique due to inexperience or fatigue in shoulder-heavy activities like climbing or weight training can increase the wear and tear of these muscles over time.
The Recovery Process
“My advice is always to keep doing what you love, but do it with modification, and be smart about it,” says Vagy. At the first sign of shoulder pain, dial back what you’re doing, avoid any moves that hurt, and correct your movement patterns. Smith seconds that—many of her patients can keep up their sports while they recover, though others do benefit from a period of rest to calm inflammation and irritation.
After two weeks of modified activity or rest—and only if the pain has lessened—Vagy suggests trying the exercises below. Only perform them if you can do each pain-free. If you have any doubts whatsoever, see a medical professional for a proper diagnosis and rehabilitation plan.
The moves are broken down into three categories: unloading, mobility, and strength. The unloading and mobility exercises are a catchall, Vagy says; they’ll work for all three of the shoulder injuries mentioned. These should be done every day, up to three times per day. The strength exercises will benefit all three injuries as well, but you can adjust the strength work based on the injury you think you might have. If you think you have a rotator-cuff strain, for example, do an extra set of shoulder rotation exercises. Perform the strength exercises every other day.
Stretches to Alleviate Tight, Achy Shoulders
Here are some stretches that you can do before a run (just warm up a little bit first so you’re not stretching cold muscles)—or after.
Pec Minor Doorway Stretch
How to do it: Stand in front of a doorway and place one elbow and forearm on the doorframe. Position your elbow slightly below shoulder height and draw your shoulder blades together. Slowly take several steps forward through the doorway keeping your elbow and forearm fixed on the doorframe. You will feel a gentle stretch in the front of your chest. Then back up slightly and rotate your body away from the elbow and forearm that are fixed on the doorframe. Stop rotating when you feel a gentle stretch in the area where your chest connects to your shoulder. Hold for 30 seconds; switch sides and repeat.
Trapezius Stretch
How to do it: Clasp your hands together behind your back and pull your shoulder blades together and down. Drop your chin to increase the stretch in your traps and then gently rock your head from side to side to stretch the muscle from different angles. Continue for 15 to 30 seconds. Rest and then repeat.
Side Shoulder Stretch
How to do it: Cross your left arm in front of your body and place your right hand on top of your upper left arm. Press against the upper left arm to increase the stretch on the side of your left shoulder. Hold for 15 to 30 seconds. As you stretch, make sure your shoulders stay down (don’t let them hunch up toward your ears). This is one rep. Rest and repeat for another rep. Switch arms and do another 2 reps, resting in between.
