Is my shoulder pain coming from my neck?

Is my shoulder pain coming from my neck?

It could be, let's find out...Have you ever reached down to pick up a shopping bag, put on a jacket, or reached into the back seat of the car, only for your shoulder to suddenly explode? You'd probably done that movement millions of times before with no bother, making this pain totally disproportionate.

If that sounds familiar, you're probably not just wondering what happened—you're trying to work out why. Was it really that one simple movement? Or was it the final straw after years of smaller injuries, habits, and niggles quietly building up in the background?
It's something I hear from patients all the time. They often have a gut feeling that there's more to the story than the moment their shoulder started hurting. As we talk, the timeline unfolds: "Well, I hurt it playing sport as a teenager... then in my twenties I started going to the gym and that shoulder never felt quite as strong... then I had a desk job... then I spent months decorating the house... and last week all I did was bend down to pick up a bag of shopping."

The truth is, pain rarely appears out of nowhere. What feels like the cause is often just the tipping point. And when it comes to shoulder pain, the real source isn't always the shoulder itself.

The Shoulder isn't alway the main problem.

When someone strains their rotator cuff or the muscles around the shoulder, one of the first questions I ask is: how did it happen?
If there was a significant fall, direct impact, or a heavy lift that clearly overloaded the shoulder, the diagnosis is often more straightforward. But many people can't pinpoint a dramatic event. Instead, the pain seems to appear during an everyday movement that shouldn't really have caused an injury.
That's when I start looking beyond the shoulder itself.
As mobility expert Dr. Kelly Starrett puts it, you have to assess upstream and downstream of the painful area. In other words, the place that hurts isn't always where the problem began.

​The very first thing I look at is someone's relaxed standing posture. Not the posture they're trying to correct because they know I'm watching—but the one their body naturally adopts.
Most people are familiar with the idea of "poor posture": a head that sits forward of the shoulders, rounded shoulders that slope forwards, an exaggerated curve at the base of the neck (sometimes developing into a noticeable hump), and, less obviously, a flattened upper rib cage. 

Another common clue is a shoulder that clicks, crunches, or pops during movement. You might hear grinding when circling your arms or notice a clunk at either end of the collarbone as the shoulder moves. These sounds tell us that the shoulder isn't moving as efficiently as it should.

Now, I could (and do) prescribe exercises to strengthen your rotator cuff, biceps, and the muscles that stabilise your shoulder blade. And if you stick with the programme, those muscles will almost certainly become stronger. But if the underlying issue is a posture that leaves your neck under constant strain, strengthening the shoulder alone is only treating part of the problem. The shoulder may feel better for a while, but the forces that irritated it in the first place are often still there. That means the next awkward reach, DIY project, or bag of shopping could be enough to trigger the same pain all over again.
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To create lasting change, we have to ask a bigger question: what is your neck and upper back asking your shoulder to compensate for every day?

So, what if your neck is the problem?

One of the first things I do is improve the position of the neck and shoulder complex by correcting the first and second ribs. It's not a traditional chiropractic adjustment, but it's a highly effective way of "opening" the upper chest.

The easiest way to describe the effect is this: imagine standing to attention with your shoulders back and chin lifted. After these corrections, many people find they naturally sit or stand much closer to that position—without consciously trying to hold themselves there. This reduces unnecessary strain through the neck and allows the shoulder to move more freely.
Then, out of curiosity as much as anything, I'll ask you to repeat the movement that was painful or restricted. Whether that's reaching overhead, putting on a coat, fastening a bra, or lifting your arm, we're simply looking to see if anything has changed. Around 8 out of 10 people notice an immediate improvement.
That instant "before and after" is often the clearest indication that the neck is playing a significant role in the shoulder pain, and it gives us a solid foundation to build on during treatment.

What can I do at home?

One of the most effective things you can do at home is identify what's placing extra strain on your neck and shoulders in the first place. For many people, it's their resting posture rather than their working posture that's the biggest contributor.

Take a look at how you sit in the evenings. Slumping, twisting, or sinking into a soft, deep sofa or armchair can place unnecessary stress on your neck and shoulders, often undoing the progress made during treatment.
Instead, try spending some time sitting or lying on the floor. I'm a fan of yoga bolsters to sit on. This can reduce the strain placed on your neck and shoulders, and help restore mobility through your hips and spine. If this isn't an option, replacing current furniture with something that encourages an upright neutral spine, high wingback chairs can be a good option.

If you would like to find out more about your neck and shoulder issues, you know where to find me.