Restore motion first.
Guided gentle movement through the range that the shoulder will allow can keep the shoulder from stiffening while the inflammation subsides. A stiff shoulder makes the next phase more difficult.
Shoulder Care Atlanta
Shoulder Pain Care in Atlanta.
Quick answer
Why your shoulder hurts, including when nothing happened to it
If your shoulder pain didn't start with a fall, it probably begins in the tendons surrounding the joint rather than in the joint itself. Four small muscles and their tendons (the "rotator cuff") keep the ball end of the upper arm bone (the humerus) centered within its socket. They pass through a very narrow space under a bony roof at the top of the shoulder, called the acromion.
Everyday activities can damage the tendons over the years, and most of the conditions we see stem from this. The cuff tendon can tear gradually due to repeated overhead activity in work or sport, with no particular incident to point to. Impingement reduces the space under the acromion, so the tendons become compressed each time the arm is raised. Calcific tendonitis involves a calcium deposit forming within a cuff tendon, and biceps tendinitis inflames the upper part of the biceps tendon where it enters the shoulder, which causes anterior (front) shoulder pain.
Arthritis is another usual cause, and its symptoms differ from those just described. Cartilage wears off both the ball and the socket, the pairing doctors call the glenohumeral joint, so the shoulder aches and loses motion. It also runs more common in women than in men. Which side hurts often tracks with the arm you use most, since arm dominance is a known risk factor alongside age and heavy overhead work.
For a flare-up, rest from the motion that sets it off, ice, and an over-the-counter anti-inflammatory usually take the edge off. None of that tells you which structure is involved.
Shoulder pain that wakes you up
The symptom that most often signals a structural problem is pain that is bad enough to wake you in the night. It is also the symptom that finally brings people in. A shoulder can be tolerable all day and still ruin sleep.
Three conditions produce it more than any others. A rotator cuff tear often shows up first as pain lying on the involved side, or pain that pulls you out of sleep with no obvious trigger. In calcific tendonitis, the calcium deposit is within a cuff tendon itself and can cause similar night pain and even severe, acute pain for a few days that over-the-counter medication cannot relieve. In impingement, the narrowed space above those tendons disturbs sleep even on nights when you barely used the arm.
The position plays a role here. Sleeping on the affected side presses the tendons against the bone above them, explaining why that side is typically the more painful. Although rearranging pillows might provide a temporary reprieve, it won't eliminate the source of the discomfort.
The appropriate treatment varies depending on whether it's a tear, a calcium deposit, or impingement. Tears are classified based on their dimensions, thickness, and the extent to which the tendon has retracted from the bone, and this classification determines the subsequent course of action. A calcium deposit is a different problem with different answers, and shockwave therapy is one of the treatments used well before surgery enters the conversation.
Recurrent night pain deserves an evaluation instead of more trial-and-error.
Shoulder pain in sport
Shoulder pain that flares up while running usually indicates a shoulder injury the runner unearths, not a shoulder injury running has produced. Running doesn't load the shoulder the way throwing or lifting does, but it does leave the arm swinging unsupported for long stretches, and that alone is often enough to bring out a tendon that was already irritated.
There are three ways sports generally damage the shoulder. Contact takes the ball out of the socket, usually out the front, after landing on an outstretched arm or a blow to the shoulder. This rarely happens cleanly, typically taking some of the labrum, the rim of cartilage that makes the socket deeper, with it. Lifting tears the tendon of the pectoralis major muscle where it inserts into the upper arm, most often on the lowering half of a bench press. Repetitive overhead activity, such as swimming, throwing, and volleyball, wears the cuff down, which is why swimmers, throwers, and volleyball players lose overhead power gradually rather than all at once.
The first dislocation matters more than it feels like it should. Many who have dislocated their shoulder once will dislocate it again, and each time it happens, some of the rim is lost, making reconstruction more difficult. A painful shoulder in a sport that places relatively little stress on it should be examined just as carefully as one injured by contact.
Exercises that help a painful shoulder
The shoulder exercises for a painful shoulder are small, controlled and unglamorous. They work in a set order: motion comes back first, then cuff strength, then the shoulder blade control that supports both.
Train the cuff, not the mirror muscles.
Rotating your forearm outwards and inwards with slight resistance, while keeping your elbow close to your body, exercises the rotator cuff. Neither the bench press nor the overhead press does this, and thus someone can be strong but still have a weak cuff.
Add shoulder blade control.
The shoulder blade's stabilizing muscles provide the rotator cuff something to pull against. Without that stability, your arm will compensate, but those same tendons will continue to absorb the stress.
Stop what reproduces the pain.
If an exercise hurts in the middle of the range as the arm is being raised above the head, stop. Don't push through it. Heavy overhead work on an inflamed tendon reliably makes the next week worse.
That is the second rule, and it applies to all four: a program built for an irritated shoulder is not the program for a torn one, because a rotator cuff tear changes how much load that tendon can safely take.
Where a tendon stays sore despite a good program, regenerative medicine covers the non-surgical options that reach past exercise. An examination decides whether any of them fit your shoulder.
When the shoulder and the elbow both hurt
I saw Dr. Langer after dislocating my shoulder and have since recommended him to friends. I was very pleased with his conservative yet effective treatment. I highly recommend him for sports medicine and orthopedic-related issues.
When the shoulder and the elbow bother you simultaneously, consider the biceps muscle. The biceps is located along the upper arm and its upper tendon enters the shoulder joint and anchors at the top of the socket, so a single structure spans both ends.
Biceps tendinitis is irritation of that upper tendon. It causes pain at the front and top of the shoulder that can travel down the front of the arm, sometimes with a clicking or rubbing feeling as the tendon shifts in its bony groove. It rarely occurs alone. A rotator cuff tear is the condition found with it most often, because a torn cuff tendon lets the biceps tendon move more than it should.
Pain in both places does not always share one cause, though. Numbness or weakness in the hand points at a nerve rather than a tendon, and the nerves that serve the hand pass close enough to the elbow to be worth examining there. If the elbow is the worse of the two, start with elbow pain and work back toward the shoulder.
How Atlanta Sports Medicine Institute works up a shoulder
A shoulder is evaluated in the same order every time. The visit opens with when the pain began, how it has changed, and what you need the arm to do again. The examination then compares both shoulders, measures motion, and tests the strength of each cuff muscle separately, because one weak tendon points somewhere different than weakness across all four.
Imaging complements the exam, but should never substitute for it. X-rays show the bones, the space left in the joint, and any bone spurs. MRI will show the status of the tendons, the labrum, and the amount of retraction of a torn tendon, which is frequently the information that makes a difference in treatment decisions. A report that says tear does not say how big the tear is, how old it is, or how much function it is taking.
The bias runs toward keeping your own tissue working. Where a well-run therapy program brings a shoulder back, that is a real answer and not a delay. Where the structure is failing and strength keeps slipping, shoulder surgery gets discussed early, because the tissue available for a repair does not improve with waiting. These are the calls that a surgeon has been trained to make. Repeatedly selected by peers since 2006 to teach shoulder, hip, and knee surgery at national and international courses. Active member of the Arthroscopy Association of North America (AANA).
Atlanta patients come in at all stages. Some have had a shoulder hurting for a week; some bring an MRI with a diagnosis they want checked; and some have nursed the same shoulder for years and want to know what it has taken from them.
In this section
Shoulder Pain
Your appointment
Start with clarity about your shoulder.
If pain is limiting the way you train, work, sleep, or move, an evaluation can turn uncertainty into a practical next-step plan.
Book an appointment →-
A focused conversation
Explain what you want to return to, not only what hurts.
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A whole-shoulder assessment
Look for the combination of findings that best explains the symptoms.
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A clear next-step plan
Understand the likely cause, whether imaging helps, and what comes next.
Atlanta Sports Medicine Institute
Care built around diagnosis, clarity, and durable function.
Atlanta Sports Medicine Institute helps active patients understand what may be driving their symptoms and compare appropriate treatment paths. The experience should be precise, understandable, and tied to the activities each patient wants to return to.
Diagnosis before treatment assumptions Nonsurgical and surgical options discussed in context Clear expectations without guaranteed outcomes A plan shaped by function, goals, and the structures involved
What exercises help with shoulder instability?
The work centers on the muscles that hold the ball in the socket, because the ligaments and the labrum that normally hold it there have been stretched or torn. The work that helps is rotator cuff strengthening, shoulder blade control, and position sense drills that retrain the shoulder to know where it sits under load. There is a limit to what physical therapy can accomplish. A large share of shoulders that dislocate once will dislocate again, and physical therapy does not repair the tissue that has become lax. You should get your shoulder evaluated before choosing physical therapy as the primary treatment.
What shoulder pain exercises should I avoid?
Avoid whatever reproduces your pain, which is more useful than any fixed list. In practice, that usually means heavy overhead pressing, wide-grip bench pressing, and dips while a tendon is irritated, plus anything that becomes painful in the middle portion of the range as the arm goes up. Once the shoulder has dislocated, add this as well: the arm out to the side, with the arm rotated backwards, because that is where the shoulder popped out of. After that, everything is contingent on what is damaged, which is the argument for getting the diagnosis before building the program.
How long is the recovery time for shoulder tendon surgery?
Recovery after tendon surgery runs in phases rather than on a calendar, and no honest answer attaches a date to it. You start with a sling. Then, the physical therapist will move your shoulder for you, followed by your shoulder moving itself. Once that happens, you can strengthen, and later you can do the more difficult overhead exercises. How long all of this takes depends on what tendon was repaired, how big the tear was, the quality of the tissue, how it was repaired and how it's healing. Your surgeon and your therapist move you forward on strength and function rather than on dates.
How do I recover from a climbing shoulder injury?
First you need to know what got hurt. Since climbing puts the shoulder in a position that places high stress on the rotator cuff tendons and the glenoid labrum, a pop at the moment of injury followed by swelling and weakness deserves an examination rather than a rest week. After the injury has been diagnosed, the treatment is very much like other shoulder injuries, which usually means treating the pain and inflammation first, restoring range of motion, then strengthening the rotator cuff muscles and the muscles that move the shoulder blades. When this has been achieved, you can slowly return to doing overhead pulls using progressive resistance and training that mimics the climbing positions. Returning to overhead pulling without proper strength is often the cause for a shoulder injury becoming recurrent.
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