The Overhead Reach Problem
Reaching overhead is something we do countless times each day. Getting items from high shelves, washing hair, putting on shirts, and reaching for seatbelts all require overhead arm movement. When this motion causes pain, it disrupts daily life in ways that matter.
Overhead shoulder pain is one of the most common shoulder complaints. Understanding why this specific movement hurts helps you take appropriate action.
Why Overhead Movement Causes Pain
Your shoulder is the most mobile joint in your body. This mobility comes with a trade-off: the structures that allow freedom of movement can also become irritated or damaged.
When you raise your arm overhead, several things happen:
Space narrows. The area between your arm bone (humerus) and the bone above it (acromion) gets smaller. Structures in this space can become pinched.
Tendons stretch and load. Your rotator cuff tendons must work hard to control the movement and keep the ball centered in the socket.
Muscles work together. Multiple muscle groups must coordinate precisely. When this coordination breaks down, pain often results.
Common Causes of Overhead Shoulder Pain
Rotator Cuff Problems
The rotator cuff is a group of four muscles and their tendons that stabilize your shoulder. These tendons pass through the narrow space under your acromion. Problems here cause pain specifically with overhead movements.
Rotator cuff tendinitis develops when tendons become irritated from overuse. Pain typically builds gradually and worsens with repeated overhead activity.
Rotator cuff tears range from partial to complete. Tears cause weakness along with pain. You may struggle to hold your arm up or feel it give way.
Shoulder Impingement
Impingement occurs when soft tissues get pinched between bones during overhead movement. The supraspinatus tendon and subacromial bursa are most commonly affected.
Pain from impingement follows a characteristic pattern. It often begins partway through lifting your arm, peaks at shoulder height, and may ease once your arm is fully overhead. This is called a painful arc.
Bursitis
The subacromial bursa is a fluid-filled sac that reduces friction in your shoulder. When inflamed, it swells and takes up space that your tendons need. This makes overhead movement painful.
Bursitis often develops alongside rotator cuff tendinitis. Both conditions can result from repetitive overhead activities or an acute injury.
Shoulder Arthritis
Arthritis in the main shoulder joint (glenohumeral arthritis) causes pain throughout shoulder movement, including overhead reaching. You may notice grinding sensations and progressive loss of motion.
Arthritis of the AC joint (where your collarbone meets your shoulder blade) causes pain localized to the top of your shoulder. This pain often peaks when your arm reaches its highest point.
Frozen Shoulder
Frozen shoulder (adhesive capsulitis) causes both pain and stiffness. Overhead reaching becomes limited by both discomfort and restricted motion. This condition develops gradually and often follows a period of shoulder immobility.
Recognizing Warning Signs
Most overhead shoulder pain responds to conservative care. However, some situations need prompt attention:
- Trauma followed by weakness: A fall or sudden force followed by inability to lift your arm may indicate a significant tear
- Deformity: Visible changes in shoulder shape suggest dislocation or fracture
- Rapid onset of severe pain: Sudden severe shoulder pain needs evaluation
- Radiating symptoms: Pain, numbness, or tingling down your arm could indicate nerve involvement
Self-Care Strategies
Many people find relief with home treatment:
Modify Activities
Work below shoulder level when possible. Rearrange frequently used items to lower shelves. Use step stools to avoid reaching high.
Take breaks during repetitive activities. If your work requires overhead tasks, build in rest periods.
Maintain good posture. Forward head and rounded shoulder posture can contribute to impingement.
Ice and Rest
Apply ice for 15-20 minutes after activities that cause pain. Ice helps reduce inflammation in irritated tissues.
Relative rest means avoiding aggravating activities while maintaining gentle movement. Complete immobilization often makes shoulder problems worse.
Exercise
Pendulum exercises help maintain mobility without stressing injured structures. Let your arm hang and gently swing in circles.
Rotator cuff strengthening with resistance bands builds the muscles that support your shoulder. Focus on external rotation and scapular exercises.
Posture exercises strengthen upper back muscles and help maintain proper shoulder position.
When to Seek Professional Help
See a healthcare provider if:
- Pain limits basic activities like dressing or hygiene
- Symptoms persist beyond two weeks of self-care
- You notice significant weakness
- Pain followed a specific injury
- You have a history of shoulder problems
Professional Treatment Options
Physical therapy remains the cornerstone of treatment for most overhead shoulder pain. A therapist can identify specific movement problems and guide appropriate exercise progression.
Corticosteroid injections reduce inflammation and provide pain relief, allowing you to participate more fully in rehabilitation.
Imaging studies including X-rays, ultrasound, or MRI help identify the specific structures involved.
Surgery becomes an option when conservative treatment fails to provide adequate relief. Procedures range from arthroscopic debridement to rotator cuff repair, depending on the underlying problem.
Moving Forward
Overhead shoulder pain is common but not something you should simply accept. With proper attention to the cause and appropriate treatment, most people can return to pain-free overhead activities. Start with self-care measures, but do not hesitate to seek professional evaluation if symptoms persist.