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10 Reasons Your Neck and Shoulders Hurt While Running

Photo: Michael Heim/EyeEm/Getty Images

When it comes to running, you might expect some pain in your lower body: tight hamstrings and hips, shin splints, blisters, and calf cramps. But it doesn’t always end there. Pounding the pavement can cause discomfort in your neck and shoulders, explains Grayson Wickham, D.P.T., C.S.C.S., founder of Movement Vault. That’s because when you run, every step is a rep, so if your upper-body form is compromised, the pain will continue to add up with every stride, he says. You can imagine what that means if you’re clocking a 7-mile run.

Sound familiar? Here are some of the top reasons you could be experiencing neck and shoulder pain during and after a run. Plus, how to fix the problem.

You clench your fists.

Tension travels up through the body, says Yusuf Jeffers, C.P.T., head coach at Mile High Run Club in NYC. So if you’re clenching your hands or making a fist while you run, you create tension that travels through your forearm and upper arm and into the trapezius muscle (directly connected to your upper back and neck), which ultimately lands in your shoulder and neck. “If your neck and shoulders hurt, try letting your hands hang as if you’re holding an egg; you don’t want to crush the egg, and you also don’t want to drop the egg,” says Jeffers. If the egg cue doesn’t work, try holding headphone wires, visualizing a fist-full of chips, or wearing a shirt with thumb-holes, he says, all of which will hopefully allow for some much-needed space in your palms.

You jut your head forward.

The weak posture you often hold at work will translate to weak posture on your runs, and one of the most common at-work positions is head forward, chin down, and back arched, explains Wickham. So if you go from an 8- to 12-hour day at work in that position, immediately into a run, it’s not uncommon to continue to move with that same weak posture. Instead, try running with what Wickham describes as a “neutral neck,” which is a neck with natural flexion (head tilted slightly down) and shoulders pressed down your back. If you have a hard time pressing your shoulders toward the floor when you run, Jeffers recommends trying to run with straight arms by your side, and then work back up to bent elbows when you feel comfortable holding a neutral neck.

You look down at the ground.

Your eyes might not seem all that important when it comes to running form, but the rest of your body will follow your gaze, so it’s important to pay attention to it. “When you run, tuck your chin in and keep your eyes up toward the horizon,” says Jeffers. Your body follows your line of sight, so if you’re looking down at the ground, it can affect the way you hold your neck, which affects the position of your shoulders and back, which in turn causes pain in your hips and knees, and so on and so forth, he says. Essentially, looking down messes with your entire running form, which is sure to cause you pain and discomfort not only in your neck and shoulders but everywhere else too.

You shrug your shoulders.

By now you know that weak posture from hunching over a computer screen doesn’t magically disappear when you head out for a run. The problem, though, is that you might try to compensate for your slouchy posture during a run by marginally pulling your shoulders up closer to your ears, says Wickham. While running with a slight shrug of your shoulders may not feel uncomfortable at first (you might not even know you’re doing it), it can cause tension and tightness in your neck if you run that way for a long distance or time, says Jeffers. This is usually when you’ll start to notice your form-when you up the mileage-because that’s when the neck and shoulder pain starts to creep in. The fix? Just drop your shoulder blades down your back a little more with each breath and be conscious of making those adjustments throughout your run.

You pump your arms across your body.

Efficiency is key, says Jeffers, and not just with your strides. “People often move their arms extraneously,” he says. “Moving your arms across your body can cause unnecessary strain in your neck and shoulders, plus it wastes a lot of energy.” Try pulling your shoulders down and back, bend your arms at a 90-degree angle at your elbow, and continue pumping, he says. “Remember, the movement is happening at your shoulder, not your elbow. And it’s not an exaggerated range of motion, it’s smooth, loose, and in control.” Your arms should be used to counterbalance your strides, not propel you forward, produce force, or use up energy, adds Wickham. (Check out more ways to improve your running technique.)

You have low mobility in your back.

Tightness in the upper and middle back will mess with even the most ideal running posture, says Wickham. Sometimes this tightness comes from sitting all day, but other times this tightness is just a result of low flexibility and mobility, or even the way you slept the night before. But the good news is that improving flexibility can help you maintain proper running posture and say goodbye to not only neck and shoulder pain, but pain just about everywhere. He recommends foam rolling, and then doing some stretches that will increase mobility in the thoracic spine (the upper middle part of the back).

Try It: Thoracic Spine Rotation

Begin on all fours fingers spread slightly. Place left hand behind your head, but keep right hand outstretched on ground in front of you. Rotate left elbow to the sky while exhaling, stretching the front of your torso, and hold for one deep breath. Switch arms and repeat.

This exercise works the back, chest, and abdominal muscles, and stretches and helps to improve mobility in your torso, while reducing stiffness in the mid to lower back, explains Wickham. (Check out eight more back moves that banish back pain and bad posture.)

Your body feels stiff all over.

If you have plans for a longer run, but can feel the stiffness from yesterday’s training still taking hold of your muscles, put your run off for a few minutes and foam roll, says Wickham. Patience pays off in the end. If you’re unable to move fluidly, the tension will travel through your body and cause trouble not only in your neck and shoulders but elsewhere. Bottom line: The less pain you feel before your run, the less pain you should feel during and after your run, he says. The importance of taking time for dynamic stretches and foam rolling for hitting the road cannot be overlooked.

You aren’t stretching properly.

Before and after you run, you should be stretching your neck, shoulders, and back, in addition to your lower body, says Jeffers. Before you head out, do a dynamic upper-body warm-up, such as follows: Nod your head forward and back on a count of four, then rotate your neck left and right for a count of four. Then, swing your arms forward and back, and side to side. “Before you head out on a run do some of the exercises you see Olympic swimmers do on the pool deck: Roll your neck and shoulders, swing your arms, and activate both the muscles and joints,” says Jeffers. Then, after the run, do some static stretching that targets the muscles that hurt the most. (Check out these go-to pre- and post-run stretches for better mobility and less pain.)

You’re dehydrated.

“Dehydration can cause cramping all over, including your neck and shoulders,” says Wickham. While there are other neuromuscular reasons why you might experience a muscle cramp, remembering to hydrate in the one- to five-hour period before you head out should help prevent it on a run. If you’re a morning exerciser, this is really important as Wickham says your body will naturally wake up dehydrated, so going for a run before you’ve had enough to drink means trouble.

You’re stressed.

When you’re stressed, your body can’t deal with the aches and pain that it might normally be used to dealing with, says Wickham. One study from Tel Aviv University, published in the journal PAIN, found that psychological stress actually reduces your ability to withstand physical pain. That means that stress can actually amplify the aches and pains you’re already feeling, says Wickham.

Plus, if you’re running in a slumped position, which research says your body recognizes as stressful, you’ll actually trigger the release of the stress hormone cortisol which means instead of decreasing your stress levels while you run (a motivating factor for many runners), you could be increasing them, he says.

So ask yourself “how stressed am I on a scale of 1 to 10, with 1 being the least stressed.” And if you’re more than a 7 or 8 in stress, you and your body would benefit from doing an activity that helps relieve stress, suggests Wickham. For some, running is that stress reliever, so if that’s you, go ahead and continue on your planned run and aim to keep a lifted chest and gaze for more optimal mental and physical results. But if you’re stressed out and running just sounds like another chore on your to-do list, try yoga, meditation, taking a bath, going on a hike, or simply focusing on two minutes of deep breathing.

  • By By Gabrielle Kassel

Our experts answer your running-related questions.

Q Should I wear lighter shoes when I run on a treadmill?
A If you have them, yes. Your joints and limbs require less cushioning as a treadmill absorbs shock far better than the road. Some shoe companies offer models specifically designed for ‘mill use, with less internal cushioning (especially at the forefoot and toes) and more external ventilation (to counter the heat-producing friction of TM belts). Or just switch out your heavyweight kicks for lightweight runners, minimalist shoes or racing flats.
– CHRIS POULOS is a running coach

Q Why do my arms get fatigued when I run fast?
A Blame tension in your neck, shoulders, upper arms and upper-back muscles. Your body is a kinetic chain – when you push your limits, you put stress on the chain and your muscles tense in a domino-like response. Immediately before your run, stretch your upper body to relieve any residual tightness. Do single-arm, overhead raises, lateral arm raises and arm circles. When you run fast, focus on keeping your neck and shoulders loose, and keep your arm swing close to your body. Periodically shake your arms out. Finally, make push-ups and pull-ups part of your routine to strengthen upper-body muscles so they last longer before becoming fatigued.
– STEPHANIE WEIGEL is a coach and personal trainer

Q I’m sore from yesterday’s run. Should I take today off?
A You can either take the day off or go for a short, very slow run. Micro-tears in your muscle tissue from a hard or long run are the likely culprit of your soreness. Backing off for two or three days helps the tissue heal and rebuild even stronger. Spend this time running easy, doing light cross-training, taking a day off, or doing some combination of the three. Light exercise is best – it stimulates more blood flow to your muscles, which will hasten the removal of waste products and help speed recovery.
– MICHELE ALLEN is a running coach and store manager

Walking should be a part of your daily routine. It helps you stay in shape and maintain your weight. You can even get some feel-good endorphins during your walk. Of course, it’s hard to feel good during a walk if you have neck and shoulder pain. If you experience neck and shoulder pain when walking, change your walking technique. This should alleviate your pain. However, if you still experience discomfort when walking, visit a doctor for an evaluation.

Drink Plenty of Water

You need to stay hydrated when engaging in any type of exercise, including walking. Many people do not realize this, but dehydration can actually make neck and shoulder pain worse. When you don’t drink enough water, you can get a headache. This causes tension, and much of that tension builds up in the neck and shoulders. Drink plenty of water before you walk and drink some more after. The extra water won’t just reduce your neck and shoulder pain when walking. It will also provide you with extra energy so that you can get more out of your walk.

Warm-up Before Walking

Your neck and shoulder pain could be due to injuries. It’s easy to injure yourself if you fail to warm up before exercising. Walking might not seem like real exercise, but it can be, especially if you push yourself. Stretch your neck and shoulder muscles before you begin your walk. Then start slowly and increase your pace. This should reduce your neck and shoulder pain when walking.

Maintain Good Posture

Shoulder and neck pain is often caused by poor posture. Stand tall and do not arch your back. Keep your eyes forward and your chin up. Your shoulders should be slightly back and relaxed. Engage your core and keep your back straight when walking.

Walk on a Flat Surface

Your neck and shoulder pain could be caused by your walking surface. If you walk along an uneven sidewalk, you will have a hard time maintaining the proper posture. Find a walking route that is flat and without hard-to-avoid obstacles. The flat surface will help you maintain your posture, so you are less likely to experience any discomfort.

Cool Down After a Walk

If you experience neck and back pain when walking, it’s important to cool down after you are done. Your neck and shoulders might carry tension from your walk. Gently stretch the muscles, so they will release the tension that can cause pain and discomfort. As you stretch, walk at a slow pace for your muscles to cool down.

Get Medical Attention If Needed

If you still experience neck and shoulder pain when walking, you might need medical treatment. Get a medical evaluation by an experienced injury doctor to see if your neck and shoulder pain is caused by an injury. Your doctor can treat the condition, so you can begin to enjoy walks without the pain. Then you won’t have any problem adding walking to your daily routine. You’ll realize just how much fun walking can be when you aren’t in pain.

Exercise advice for shoulder pain

How does the shoulder work?

The shoulder is the most mobile joint in the body.

The main shoulder joint is a ball-and-socket joint, which allows a very wide range of movement.

The joint is surrounded by a tough fibrous sleeve called the capsule, which helps to hold the joint together.

A group of four muscles and their tendons make up the rotator cuff, which controls movement and also helps to hold the joint together.

There’s another smaller joint where the top of the shoulder blade meets the collarbone, the acromioclavicular joint.

What causes shoulder pain?

There are many causes of shoulder pain, but most cases will only affect a small area and are relatively short-lived. Shoulder pain may also be part of a general condition such as rheumatoid arthritis or osteoarthritis.

Shoulder pain isn’t always caused by a problem in the shoulder joint – problems in the neck can cause pain that’s felt over the shoulder blade or in the upper outer arm.

What can be done to help?

If your pain has a particular cause, like arthritis, treating that condition may help. Following the self-help tips and exercises here will also help, but if your pain isn’t improving after about 2 weeks then you should speak to your GP.

Medication

Painkillers such as paracetamol and ibuprofen may help and you should use them if you need to. It’s important that you take them regularly and at the recommended dose to help you control the pain and allow you to continue exercising. Don’t wait until your pain is severe before taking painkillers. You can also rub antiinflammatory cream directly onto the painful area.

You shouldn’t take ibuprofen or aspirin if you’re pregnant or have asthma, indigestion or an ulcer until you’ve spoken to your doctor or pharmacist. Medication can have side-effects so you should read the label carefully and check with your pharmacist if you have any queries.

Physiotherapy

If your shoulder pain is affecting your activity and is persisting, ask your GP about referral to a physiotherapist. Physiotherapy can help you to manage pain and improve your strength and flexibility. A physiotherapist can provide a variety of treatments, help you understand your problem and get you back
to your normal activities.

Rest and exercise

Aim for a balance between rest and activity to prevent the shoulder from stiffening. Pace yourself to start with and try to do a bit more each day. Try to avoid movements that are most painful, especially those
that hold your arm away from your body and above shoulder height. It’s important to remain active, even if you have to limit how much you do.

Posture

Don’t sit leaning forwards with your arm held tightly by your side. This position can make the problem worse, especially if some of the pain is coming from your neck. When sitting, keep a pillow or cushion behind your lower back with your arm supported on a cushion on your lap.

Reducing the strain

When raising your arm or lifting objects, reduce the strain or pull on your shoulder by:

  • keeping your elbow bent and in front of your body
  • keeping your palm facing the ceiling.

To lower your arm, bend your elbow, bringing your hand closer to your body.

Your pain should ease within 2 weeks and you should recover over approximately a 4–6 week period.

You should carry on with the exercises overleaf for at least 6–8 weeks to help prevent symptoms returning.

If you have severe pain or your symptoms haven’t improved after 2 weeks, contact your doctor.

Simple exercises

Pendulum exercise

  1. Let your other arm hang down and try to swing it gently backwards and forwards and in a circular motion.
  2. Repeat about 5 times.
  3. Try this 2–3 times a day.

Shoulder stretch

  1. Stand and raise your shoulders.
  2. Hold for 5 seconds.
  3. Squeeze your shoulder blades back and together and hold for 5 seconds.
  4. Pull your shoulder blades downward and hold for 5 seconds.
  5. Relax and repeat 10 times.

Door lean

  1. Stand in a doorway with both arms on the wall slightly above your head.
  2. Slowly lean forward until you feel a stretch in the front of your shoulders.
  3. Hold for 15–30 seconds.
  4. Repeat 3 times.

This exercise isn’t suitable if you have a shoulder impingement.

Door press

a) Stand in a doorway with your elbow bent at a right angle and the back of your wrist against the door frame.

  1. Try to push your arm outwards against the door frame.
  2. Hold for 5 seconds.
  3. Do 3 sets of 10 repetitions on each side.

b) Use your other arm and, still with your elbow at a right angle, push your palm towards the door frame.

  1. Hold for 5 seconds.
  2. Do 3 sets of 10 repetitions on each side.

Summary

  • Most cases of shoulder pain aren’t caused by anything serious and will ease within 2 weeks.
  • You can take painkillers to ease pain. Taking them before exercise can help you stay active without causing extra pain.
  • Using an ice pack, learning how to protect your joints and being aware of your posture will help cases of shoulder pain.
  • Try the exercises suggested here to help ease pain and prevent future symptoms.

PDF version

To make it easier for you to print these exercises we have created a PDF version, suitable for home printing.

Acknowledgements

This content has been authorised for use by Arthritis Research UK.

Video exercises to help with shoulder pain

Having read this advice sheet, these videos may help you to follow the exercises.

More health advice

See our guides on:

  • exercise advice
  • sporting injuries
  • keeping active and healthy

Moderate Risk Shoulder Pain Causes

11. Acromioclavicular (ac) joint injuries (more serious grades)

We’ve already discussed less serious ACJ injuries. More serious grades of the condition require regular treatment as the discomfort can continue to worsen over time. Rest, physical therapy, and over the counter pain medications can all help to alleviate some of the pain and discomfort of advanced ACJ, but more drastic options may be needed if your pain is constant and severe.

Steroid injections are sometimes advised to treat severe pain, and these injections help alleviate pain by reducing swelling and improving mobility in the shoulder.

Surgery is also an option for severe cases. During surgery, loose pieces of damaged cartilage can be removed and the joint can be modified to reduce friction. In some cases, a small piece of the clavicle is removed to lessen friction as well. With the right treatment plan, pain management can be a success.

12. Bursitis

Bursae are small, fluid-filled sacs that are situated in joints all through the body including the shoulder. They function as cushions between bones and the surrounding soft tissues. They help to minimize friction between the gliding muscles and the bone.

Occasionally, overuse of the shoulder results in inflammation and swelling of the bursa between the rotator cuff and the section of the shoulder blade referred to as the acromion. This lead to a condition referred to as subacromial bursitis.

Bursitis frequently accompanies rotator cuff tendinitis. With bursitis, a number of tissues in the shoulder can get inflamed and cause pain. You may find it difficult to carry out most day to day activities like combing of hair or getting dressed.

13. Acute and Chronic Shoulder Tendinitis

Over time, tendinitis can become more advanced..

In general, more advanced cases of tendinitis can be classified into one of two categories:

  • Acute tendinitis: which is typically caused by repeat actions, such as throwing a ball or other activities requiring one to raise their arms over their head.
  • Chronic tendinitis: is typically caused by degenerative diseases like arthritis or repetitive wear and tear on the shoulder joint as a result of aging.

Therapy for tendinitis usually focuses upon regaining range of motion in the shoulder through exercises and physical therapy, lessening pain through either prescribed pain medication or over the counter pain medications, using anti-inflammatory drugs and cortisone injections to ease inflammation in the shoulder area, and frequent appointments with a doctor to monitor progress of the healing and to strategize any further needed action.

For very severe cases of tendinitis, surgery is sometimes recommended but only if and after every possible attempt is made to alleviate pain and discomfort through less drastic actions.

14. Bicep Tendon Injury and Tears

Shoulder muscles are attached to bones with tendons. If you tear the biceps tendon in your shoulder, you might find yourself with less strength in the affected arm and the inability to turn your arm from palm down to palm up.

The split and tear of tendons can result from acute injury or degenerative changes in the tendons. This is usually caused by increasing age, long-term overuse and wear and tear, or a sudden injury.

Bicep tendon tears can either be partial or complete. Most are partial, where the tendon is not completely severed. But without treatment, the tendon can continue to tear and eventually separate into two pieces. This is, of course, very painful and eradicates all possibility of movement at that point.

In many instances of complete tears, the tendon pulls away from its site of attachment to the bone. Rotator cuff and biceps tendon injuries are among the most widespread types of these injuries. Injury and overuse of the shoulder are the most common causes.

Symptoms of a bicep tear include sudden and sharp upper arm pain accompanied by an audible snapping noise, bruising from the middle of the upper arm that goes towards the elbow, and a bulge in the upper arm above the elbow.

A physical exam is typically all that’s needed to diagnose a biceps tendon tear. Treatment includes applying ice several times a day to the injured area, resting the arm and shoulder, pain medications (over the counter or prescribed, depending upon the severity of the pain and doctor’s recommendations) to lessen discomfort, and physical therapy to restore movement. Surgery is rare but could be needed for a severe tear or one that keeps reoccurring.

15. Brachial plexopathy

Brachial plexopathy is caused by a nerve problem in the neck and shoulder area. If there is damage to the brachial plexus, an area found on both sides of the neck containing nerve roots from the spinal cord, brachial plexopathy can develop.

Causes of the brachial plexopathy include birth defects that put pressure on the nerves, exposure to toxins, and inflammatory conditions.

Symptoms include numbness of the shoulder, hand, or arm, generalized shoulder pain, weakness, and tingling or burning in the injured area.

Blood tests and x-rays are usually needed to diagnose brachial plexopathy.

Treatment focuses on addressing the underlying cause.

You can recover on your own from brachial plexopathy. But for those who don’t notice an improvement in due time, physical therapy is often advised.

With brachial plexopathy, over the counter pain medications are usually enough to lessen pain and enable movement of the shoulder without much discomfort. If not properly diagnosed and treated, however, deformity of the arm or hand can occur along with partial arm paralysis.

If you’re experiencing pain along with tingling and weakness in your shoulder, seek medical attention.

16. Cervical radiculopathy

Cervical radiculopathy is more commonly known as a pinched nerve. This condition occurs when a nerve in the neck is irritated or compressed, forcing it to branch away from the spinal cord.

The pain of a pinched nerve tends to radiate into the shoulder and cause muscle weakness and numbness that can reach through the arm and into the hand. Arthritis is a common cause for a pinched nerve in the shoulder, but pinched nerves often occur because of injuries as well.

A common symptom described by those with pinched nerves is a “pins and needles” sensation in the affected area.

If you suspect a pinched nerve problem, try placing your hands on topof your head. If the pain decreases, a pinched nerve is most likely the cause of your discomfort.

Treatment is normally not necessary, with the condition improving on its own with time. To manage pain, over the counter pain medications are advised along with cold and heat treatments. Physical therapy is an option for stubborn cases of pinched nerves and, in rare cases, surgery might be necessary to relieve the discomfort for good.

17. Recurrent subluxation of shoulder (Partial to Recurrent Partial Dislocation of the Shoulder)

Shoulder instability is typically caused by a sudden injury or through repeated motions. Shoulder instability, also called a partially dislocated shoulder, occurs when the head of the upper arm bone is forced out of the shoulder socket. Shoulder dislocations can be partial, when the ball of the upper arm comes out just partially out of the socket. When this happens, it is known as a subluxation. If the shoulder continuously slips partially out of place, it is known as recurrent subluxation of the shoulder.

Signs of this condition include consistent shoulder pain, repeated dislocations, repeated occurrences of the shoulder giving out during activities, and a persistent loose feeling in the area. Repeated episodes of subluxations can lead to an increased risk of developing arthritis in the joint.

An MRI can help diagnose shoulder instability.

For treatment of subluxations, nonsurgical options are always recommended first, such as modifying activities to lessen the risk of shoulder dislocation, and exercise and physical therapy to improve strength in and range of motion of the joint. When shoulder ligaments are extremely damaged, surgery is sometimes recommended. Physical therapy is also necessary when recovering from these types of surgeries to help the patient regain as much mobility as possible.

18. Repetitive shoulder strain injury

Repetitive strain injuries are some of the most common injuries of all kinds seen by hospital physicians. Shoulder strains caused by repetitive actions are very common, especially in individuals whose careers involve repeated lifting of objects or in athletes who challenge the shoulder muscles in the same way every day. Repetitive shoulder strains can be caused by simple tasks such as reaching for objects high on shelves, cleaning, or throwing a ball.

Signs of a repetitive strain injury in the shoulder include burning, aching, and shooting pains along with tremors, clumsiness, and numbness. Weakness in the hands and forearmcan make it nearly impossible to perform simply tasks, like opening doors or writing. Cold hands are also common, especially in the fingertips.

Causes of a repetitive strain injury include fast and repetitive movements, working in cold conditions, and not allowing the body to properly recover after strenuous activities. The muscles, tendons, joints, and nerves in the shoulder can all be damaged with a repetitive strain injury. Catching a repetitive strain injury early is crucial. When left untreated, pain can become permanent.

Repetitive shoulder strains are treated much in the same way as shoulder tendinitis or bursitis. Doctors recommend the individual avoid further strain to the area, seek relief with over the counter pain meds, and may prescribe anti-inflammatory drugs to ease swelling and inflammation at the shoulder site. A physical therapist is typically recommended to help the individual regain a full range of motion with these types of strains. Warm water soaks in Epsom salts can also help reduce stiffness and ease the pain of shoulder strains.

19. Arthritis

Arthritis is another common cause of shoulder pain. There are different types of arthritis. The most widespread type of arthritis in the shoulder is osteoarthritis, which is also referred to as “wear and tear” arthritis. With this type of arthritis, the most common symptoms are swelling, pain, and stiffness. The typical onset of osteoarthritis is middle ate and after.

Osteoarthritis develops gradually with pain that increases as the condition worsens over time.

Osteoarthritis may be connected to sports or work injuries and acute wear and tear on the shoulder joint. Other types of arthritis can be caused by rotator cuff tears, infection, or an inflammation of the joint lining.

Frequently, individuals are advised to avoid shoulder movements that strain the shoulder area to reduce arthritis pain. This lack of movement, however, occasionally results in a tightening or stiffening of the soft tissue parts of the joint, leading to a painful limitation of movements.

20. Rheumatoid arthritis (RA)

.Rheumatoid arthritis is an autoimmune disease that usually affects the hands and feet first but can attack the shoulder joints as well. RA causes joint problems and can cause pain, stiffness, and greatly limit movement in the part of the body affected.

The cause of rheumatoid arthritis is an autoimmune condition. With these types of diseases, the immune system mistakes the body’s own cells for invaders. Rheumatoid arthritis occurs when antibodies improperly attack your own bodily tissues, causing an inflammation response. Painful swelling occurs that can cause joints to become deformed and which can lead to bone erosion as well.

Other symptoms of rheumatoid arthritis include fevers and fatigue.

There is no cure for rheumatoid arthritis and for some, symptoms come and go. Care by a rheumatologist is recommended to deal with symptoms and discomfort.

21. Rotator cuff tear

As discussed above, the rotator cuff is a group of four muscles that cover the head of the humerus. They attach the bone to the shoulder blade, allowing you to lift and twist your arm.

Rotator cuff pain is caused by a tearing of the supraspinatus muscle, which lies on top of the shoulder. Its tendon moves under the bone on the outside of the shoulder (the acromion). This tendon is one of the most frequently torn because of its location between the bones. While the tendon tears, it becomes sore and swollen and can then become stuck between the shoulder bones. It can as well damage the sac of fluid that cushions the tendon.

The rotator cuff is a common site of shoulder injuries. The most common injuries to the rotator cuff are tears, strains, tendinitis, and bursitis.

A rotator cuff tear can weaken the shoulder and make daily activities very painful.. Several factors can cause one of the rotator cuff muscles to tear, including repetitive stress from repeating the same motions, a lack of blood supply, and bone overgrowth that occurs with age.

How to know if you are having rotator cuff pain

If you have a rotator cuff injury, you will typically notice that your pain is located in the front or on the outside of the shoulder. This pain is usually worse when you raise your arm or lift something above your head. The pain can be very severe, so much so that it can prevent you from performing even the simplest of tasks. Rotator cuff tears are usually very painful at night because lying down stretches many of the muscles in this area and the pressure of the mattress against the torn cuff can aggravate the tear and can keep you from sleeping comfortably.

Symptoms of Rotator Cuff Tear

Rotator cuff tear symptoms include pain that doesn’t lessen during rest or shoulder pain at night, shoulder pain when lifting an arm, and a crackling sensation when the shoulder moves. A rotator cuff injury test or a drop arm test could be needed for diagnosis. Sudden tears are usually more painful than gradual tears. A rotator cuff tear requires treatment or it will continue to get worse. For most, adequate rest, strengthening exercises, and performing rotator cuff stretches is enough to heal the tear. For some, steroid injections can alleviate rotator cuff pain. If your torn rotator cuff symptoms last more than six months, surgery may be recommended to alleviate discomfort and restore range of motion. Of course, physical therapy is most helpful, even if surgery is not necessary, to overcome rotator cuff injuries of all kinds.

What causes a rotator cuff injury?

Rotator cuff injuries can vary from mild to severe. They usually fall into one of three categories.

Tendinitis is an injury caused by excessive use of the rotator cuff. This makes it get inflamed. Tennis players, who make use an overhead serve and painters who need to reach upward to carry out their jobs regularly suffer from this injury.

Bursitis is another widespread rotator cuff injury. It’s caused by inflammation of the bursa. These are fluid-filled sacs that are situated between the rotator cuff tendons and the underlying bone.

Rotator cuff strains or tears often result from excessive use or acute injury. The tendons that link up muscles to bones can overstretch (strain) or tear in part or entirely. The rotator cuff can also strain or tear after a fall, a car accident, or after a sudden injury. These injuries basically result to intense and instant pain.

22. Whiplash

Whiplash occurs when a person’s head moves backward and then forward suddenly with great force. Whiplash is actually the result of the muscles and ligaments of your neck extending beyond their standard range of motion.

Whiplash is often associated with neck injuries, especially from a rear-end car collision during car accidents. It can also result from physical abuse, sports injuries, or amusement park rides. But the injury can also cause general or front shoulder pain, similar to the way a neck strain would. Besides the expected symptoms of neck pain, neck stiffness, headache, dizziness, and other such common symptoms, whiplash can also cause pain in the shoulders, arm pain and heaviness, sleep disturbances, and depression. Whiplash is often viewed as a relatively mild condition, but it can result in long-term pain and discomfort.

In mild cases, whiplash and all associated symptoms will improve in a few weeks, while severe cases usually require three months of healing time. Treatment is noninvasive and involves applying ice to reduce inflammation, taking over the counter pain medication, and completing exercises to improve muscle strength. Surgery is almost never recommended for whiplash injuries.

Running is a sport that uses your legs. That’s pretty obvious. So when I was training for my last half-marathon and started noticing that my shoulders and neck were sometimes sore the day after I went on long runs, I was confused. It made sense for my lower body to feel all the work, but it didn’t seem right that logging miles would take a toll on my upper body, too.

Turns out, feeling this neck and shoulder discomfort during or after running is a sign that you’re letting your posture slip. “Every step you take a on a run can be considered a rep, and if a runner finds herself in a compromised upper body position, it comes as no surprise that tension in the neck and shoulders build as the reps add up,” Katie Harper, D.P.T., of Bespoke Treatments Physical Therapy, tells SELF. “Just like we have the tendency to hold poor postures sitting at work, believe it or not, this can also become a problem while we run.”

Harper says the most common form mistakes that lead to neck and shoulder discomfort are slouching, jutting your head outward, and rounding your shoulders forward and elevated toward the ears. If you’ve ever tried to run a little more than you’re completely comfortable with, it’s likely your form has suffered a bit—whether it was enough to cause discomfort or not. Sometimes people feel it in their lower back—if the core and hips aren’t able to support the sustained running motion, your pelvis may rotate and end up putting pressure on your lower back. Others, like me, notice it in their neck and shoulders.

Harper says there are a few factors that can lead to this poor positioning, but the most likely culprit is lack of flexibility in the upper and middle spine (called the thoracic spine) and internal rotator muscles of the shoulders. “Tightness in these areas will pull an individual out of their ‘ideal’ running posture,” she says. The good news is that targeting and improving flexibility can help you assume and maintain proper posture throughout your runs, staving off neck and shoulder aches. Below, she demos some stretches that you can try—she recommends doing them after a run, at least three times per week—to improve flexibility and release tension in your neck and shoulders.

And when you go out for your next run, do a quick posture check. “Focus on keeping your shoulders back and down and away from your ears, pinch your ribcage down toward your hips, and let your arms swing freely while your fists point forward. Remember, your arms should be used to counterbalance your stride, not to produce force,” Harper says. If you start to feel anything in your neck or shoulders, do a quick body check and tweak your positioning.

Here are four moves that will help fix tightness in your neck and shoulders: Thoracic opener done with foam roller

Is your workout giving you a stiff neck?

Try these quick fixes to stay active and avoid neck pain.

Updated: December 15, 2019Published: September, 2017

Physical activity is important to feeling great and staying healthy. But the wrong execution of a particular move, such as a golf swing or swimming stroke, may wind up causing neck pain. “Often people don’t realize their activity is to blame,” says Emily Roy, a physical therapist with the Sports Medicine Center at Harvard-affiliated Massachusetts General Hospital.

Neck pain after working out: What goes wrong

Neck pain may result from overuse of muscles in the neck and shoulder (many shoulder muscles also attach to the neck), strain on the joints in the neck, or a pinched nerve in the neck or shoulder area.

Roy says one of the biggest contributors to neck pain is poor posture during an activity. “Instead of pulling the chin down for a neutral posture, some people keep the chin forward and shoulders slouched. That makes the chin stick out and creates tension in the neck and surrounding muscles,” Roy explains.

The trapezius muscle takes the brunt of that stress. It’s a large diamond-shaped muscle that starts at the base of the skull, widens at the shoulders, and reaches halfway down the back.

“It’s a dull, achy pain,” Roy says. “Or you may get headaches from the muscles at the base of the skull. In the extended neck position, they tighten and get irritated.”

Avoiding neck pain

Here are some ways in which common activities lead to neck pain, and quick fixes to counteract bad form.

Cycling. Leaning over to reach the handlebars of a road or mountain bike can cause you to round your back and hunch your shoulders up to your ears.

Quick fix: Bring your shoulder blades down and back as you lean forward. “It’s a subtle motion while still leaning forward. Get your shoulders away from your ears, slightly arch your back, and stick out your chest,” Roy explains.

Gardening. Crouching and looking down, reaching very far and lifting heavy objects all stretch your neck in a way that strains neck muscles.

Quick fix: Pull your chin back as you look down; take frequent breaks; stay close to the area you are working in; use your leg muscles to help lift heavy objects.

Swimming. When doing the crawl, always turning your head to the same side to breathe builds muscles on one side of the neck and shortens muscles on the other side; doing the breaststroke may strain neck muscles.

Quick fix: Alternate swimming strokes (crawl, breaststroke) periodically; when doing the crawl, alternate the breathing side occasionally.

Golf. Extending the neck while you swing causes tension; carrying a golf bag on the same side all the time leads to uneven muscles and pain.

Quick fix: Bring your chin toward your neck as you look down at the ball so your neck is not extended; alternate shoulder sides when you carry a golf bag.

Yoga. Looking up when doing a “downward dog” position can extend the neck; turning your neck too far when looking behind you can stress the neck joints.

Quick fix: Keep your chin toward your neck for a neutral position; limit how far you turn your head.

Move of the month

Neck stretching: Side-bending range of motion

  • Face forward and let your head bend slowly to the side.
  • Hold three seconds and repeat on the other side.
  • Repeat 10 times.
  • Do this exercise slowly and gently.
  • For an additional stretch, when your head is bent to the side, let it roll slowly forward about 45 degrees and hold it there for three seconds.

Neck pain relief and prevention

Gentle stretches may help relieve your neck pain (see “Move of the month”). “Slowly tip the head to the side — ear to shoulder — then do the same on the other side. But don’t do this if it increases pain,” warns Roy.

Remember that using the proper form during physical activity prevents neck pain— so does strengthening the neck, shoulder, and core muscles.

For more ideas, you can check out the Harvard Special Health Report Neck Pain (www.health.harvard.edu/neck).

Image: © Goodluz/Getty Images

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Neck & Back Pain


If pain continues a few weeks after following these suggestions, your injury may be more serious than you can handle alone. You may be suffering from a condition that involves more than just muscles.
The health of the spine is dependent upon the individual movement of each of its 24 vertebrae. When one of these joints becomes injured and doesn’t move the way it is supposed to, it can cause irritation of the nerve that runs between the vertebrae. These nerves control every function of the body, including the voluntary muscles of the spine. When irritated, they cause muscles to spasm. Spasm causes pain.
The condition where abnormal function of a joint is interfering with a nerve is called a subluxation. Chiropractors are doctors who specialize in the relief of this condition without the use of drugs or surgery. Getting your spine checked for subluxations may be the key that will break the injury/pain cycle for you.
Pain takes all of the pleasure out of running. By following these simple suggestions, you may find relief and once again enjoy a great sport and your special time.
Dr. Williamson founded the West Coast Heelers Running Club in Santa Cruz, California. The club sponsors Special Olympics while raising awareness of the benefits of regular exercise in the community. He is also in private practice, where he works with patients to help them reach their maximum health potential.

If you are experiencing aching or cramping of the shoulder muscles during running, caused by too much tension or poor form, try shaking out your arms and droping your shoulders.
Try using a “two-two” breathing rhythm, in which you take two steps while inhaling and two while exhaling, and breathe from your abdomen rather than your chest.
Or try this: Put your hands on top of your head and pull your elbows backward until you feel a stretch. Run this way for 15 seconds, then shake your arms or circle them in a windmill motion to loosen the tension in your shoulders. Do range-of-motion exercises for the neck and shoulders: tilt your head up and down and side to side, shrug your shoulders or turn your head to look right and then left.
And keep checking your form as you run. Imagine a helium balloon attached to the front of your chest, pulling it forward and up. Your spine should be elongated, pelvis relaxed, shoulders dropped into a comfortable position and arms bent at about 90 degrees, and your body should have a slight forward lean.

Shoulder pain from running

Sep 21st, 2017

Good Morning,
I was wondering if you would be able to point me in the right direction,
I am currently training for the London Marathon 2018 – I have been training
for a few months now and noticed that a couple of times when I am completing
a ‘longish’ run (the longest I’ve done so far is 7.5 miles) after a certain
amount of miles, I start getting a pain in my left shoulder blade area.

It feels like trapped wind or something like that. Sometimes it’s not painful
enough that I have to slow down or stop but I notice it and have to move my
shoulder around a little bit to ease it up, other times it has been quite
painful but I can still run through it if that makes sense.

Is this something I need to worry about?

Do you think I need to contact my doctor or get a massage or something?

As I say it doesn’t happen on every run, it happened to me last night but
other than that I hadn’t felt that for a few months?
Any advice you have would be appreciated 🙂
Thanks
Charlotte

The Guru Responded:

Morning

This is one of the most poorly managed type of running injuries – and it absolutely shouldn’t be.

First up – where you feel it, isn’t anywhere near the issue comes from!

As you start to run distance and fatigue sets in, your running form alters. You start leading more with your chin as your heavy head over takes your body and your thoracic spine stiffens as you breath deeper and longer.

The pain your feel in (behind) your shoulder blade is when a nerve becomes irritated in your neck because you poke your chin out and bounce on it as your run.

You need to do a few things.

Improve your thoracic mobility, especially pre run. Improve your running strength (you should have a decent lunge/squat program). Improve your running form (see a run coach!). Don’t be lead by your chin – run chest up (not out or stiff) relax your shoulders and reach your arms forward. Run quiet – try a few runs without headphones and try to make as little running noise (foot impact) as poss. Make sure your work station (or where you spend the majority of your day) is optimised.

You’ve got plenty of time to train smart – so well done. This is super simple to over come, now you know the cause of it.

Happy running

Shoulder hurting on a run? Cramps? Pain that you can’t shake off? It’s annoying but normal and (thank goodness) definitely treatable. “The number one cause is usually tension,” said Nirav Pandya, MD, an associate professor of orthopedic surgery at UC San Francisco. As much as we think of running as a lower-body exercise, you’re really moving and working your entire body, he told POPSUGAR. If you’re getting shoulder cramps and pain regularly, it’s time to focus on your upper body, breathing technique, and overall running form.

Causes of Shoulder Pain During a Run

At the beginning of a run, your body tends to be loose: swinging arms, upright posture. But as fatigue sets in, Dr. Pandya explained, “there’s a tendency to kind of tighten up around your shoulder and neck.” You lean forward and bring your arms closer to you. Pain and cramps in your shoulders can be the result.

Another potential culprit: your breathing. You may have experienced this before; as you get tired, you’ll start breathing more in shorter, shallower gasps. That’s not only less effective in terms of getting oxygen to your muscles, Dr. Pandya said, but also increases stress on your chest and shoulder muscles. Again, that tension can lead to uncomfortable cramping.

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The last main possibility, Dr. Pandya told POPSUGAR, is overall weakness in your upper body. “As runners, we have a tendency to concentrate a lot on our lower bodies, and we don’t do a lot of upper-body strengthening,” he said. It’s understandable but essentially a mistake. Your arms and upper body need strength to push you through any kind of run, whether long and slow or short and fast, and neglecting to train that area might lead to shoulder pain down the road.

Improper hydration could also be a cause, though Dr. Pandya said that’s more likely to cause cramps in your lower body. If you address the other issues and are still having trouble, he recommended upping your electrolyte and water intake as well as double-checking that your diet has plenty of nutrient-dense fruits and vegetables.

How to Treat Shoulder Pain During a Run

The top thing is to focus on your form, Dr. Pandya said. In a previous interview, Equinox run coach Michael Olzinski, MSc, said proper upper-body running form involves “a nice, relaxed arm swing, where your arms are generally at your side near your ribcage or pushing behind you,” making sure your hands aren’t spending too much time in front of your body. Consciously loosen and relax your upper body. Shake out your shoulders, and let them shrug up and down to encourage them to move naturally. You can even warm up your arms with some jumping jacks before you head out.

To improve cramps caused by poor breathing, inhale and exhale longer and more deeply, Dr. Pandya said. Try timing your breaths between steps. “Say, ‘Every five strides, I’m going to take a nice, deep breath,’ as opposed to that short, shallow breath,” he told POSUGAR. That’s especially important when you’re doing speed work, which can throw off your rhythm and leave you gasping for air.

If those quicker fixes still aren’t helping, look to improve your hydration and upper-body strength. “Really concentrate as much on your upper part of your body as much as your lower part,” Dr. Pandya said. If you’re short on workout time throughout the week, go for a full-body workout that includes upper-body moves, aiming to complete it two to three times a week. You can also add more upper body-only resistance training to your schedule. This 20-minute weighted circuit is a good place to start. Either way, working those more-neglected muscles can give you the strength to push through your hard runs without pain in your shoulders.

Image Source: Getty / FatCamera

BT Forum

Not real clear from this if the shoulder pain was a one-off thing or repeatedly happens when you run, or whether the onset was sudden or gradual. Does it only hurt when you run, and stop when you do, or also at other times? If you have any risk factors for heart disease, you might want to get a check-up to rule that out–angina and heart attack can caused referred arm and shoulder pain. Barring that, to me it sounds like a pinched nerve or possibly strained/pulled muscle. Lots of causes but running is not the most likely–could be an increase/change in lifting, swimming, bike position, even yardwork or long hours at the computer, or sleeping on it “funny”. Or maybe the cold, general fatigue, or tension from life stresses is causing you to cramp up–running may not be the cause, you just notice it then.

On the other hand, cold weather and fatigue might be causing you to carry your arms too high with too much tension when you run, and this could possibly lead to pain. (In my experience, though, more likely to manifest as tightness or ache rather than sharp pain, although maybe the latter is possible if you managed to irritate a nerve.) I’d suggest wearing a hat to keep your head warm, overdressing a bit on top to start, maybe wearing a compression base layer, and swinging your arms around whenever you feel your upper body becoming tense. I often swing them across each other, in front and back (the way you see Olympic swimmers warming up) if I feel I’m getting tight–esp. in a long run or race (particularly the run leg of a longer tri, when your upper body can be fatigued from the swim and aero on the bike). Otherwise that tension can easily spread to your core and legs. It might look funny but it helps me keep a relaxed stride and steady pace.

Shoulder pain during running

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