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Shoulder pain through the decades of life

Shoulder Pain through the Decades of Life

by Shelia M. Tenny, OTR/L, CHTLeave a Comment

Shoulder pain can be a cause for concern for adults or teenagers. Shoulder pain accounts for 16 percent of all musculoskeletal conditions. Some shoulder pain can be from an apparent injury or fall, while others can creep in with no known event. Based on one’s age, occupation, and previous sports participation, shoulder pain can often be broken down into predictable categories based on one’s age.

Teens and Twenties

Muscle Tightness

Teenagers and those in their twenties do not often experience rotator cuff tears or arthritis. Their shoulder pain is usually from instability or tight muscles if there is no injury or impact. This tightness can place excessive force on some muscles. It can also cause altered positioning of the shoulder blades regarding to their height or distance from the spine. Another type of tightness in the front shoulder can limit the inward rotation of the shoulder or the ability to put your hand in your back pocket.

When there is tightness in one area, there is often laxity in another area. In all these scenarios, pain impacts a young person’s ability to participate in sports activities and eventually affects their shoulder health later in life. Fortunately, all these conditions respond well to stretching tight muscles and strengthening weak muscles to improve muscular imbalance, decreasing pressure on painful areas.2


Imbalance and weakness of muscles around the shoulder blade and shoulder, along with the participation in contact sports, makes this population more likely to incur a shoulder dislocation. Shoulder dislocation is when the humeral head comes out of the socket. Qualified medical personnel should treat all dislocations first to put the bones back into place. Follow-up visits may include imaging to assess if there has been damage incurred to the bones and assess the joint’s stability. If there is no bone damage, a qualified physical therapist or occupational therapist can treat this to decrease pain and restore stability to reduce the likelihood of future dislocation.1

Thirties and Forties

Rotator Cuff Tendinopathy

The following shoulder concern, rotator cuff tendinopathy, arises in your 30’s to 40’s. This condition causes pain in the tendons of the shoulder’s rotator cuff and typically coincides with increased overhead activity. This could be from weightlifting, swimming, tennis, baseball, volleyball, or manual labor. Pain can result from starting a new workout regimen or after a home improvement project such as painting or other home repairs – movements that typically aren’t performed often. The pain can be sharp or severe at the onset. The overused tendons do not heal properly, resulting in pain and inflammation. This type of injury responds well to physical or occupational therapy, which involves stretching and targeted strengthening of the muscles that are attached to the shoulder blade and humerus while decreasing pain in the cuff tendons and musculature.3,4,5

Forties, Fifties and Upward

There can be several likely causes of shoulder pain in the forties and beyond, including cuff tears, adhesive capsulitis, and arthritis.

Rotator Cuff Tear

Rotator cuff tears typically cause pain on the shoulder and arm’s lateral (side) aspect, which may radiate down the arm, but no further than the elbow. Weakness, pain with motion, and night pain are all common. Rotator cuff tears can be caused from an injury such as a fall or repetitive trauma. A small tear or a partial thickness tear, both can respond well to conservative treatment, including physical or occupational therapy.

Adhesive Capsulitis

Adhesive capsulitis is also common for this age group and may be seen more frequently in individual with diabetes or thyroid disorders. This condition occurs when the shoulder joint capsule becomes tight and thickens, restricting shoulder mobility. The cardinal signs of this are a painful shoulder with a sudden and severe loss of active motion and resistance to passive movement.


Arthritis can either be at the ball-and-socket joint or where the collarbone and the shoulder blade meet. A history of collision sports or weight lifting are more likely to lead to arthritis at the collarbone and the shoulder blade. With arthritis, the onset of pain is typically in someone over 50, with a gradual increase in pain and loss of motion.1

Seek Help for Your Shoulder Pain

Aging is a part of life and the good news is that with all of these conditions, therapy is one of the first lines of defense. Skilled physical or occupational therapists can help to correct muscle imbalance, correct tightness, alleviate pain and restore strength regardless of the cause of your shoulder pain. Meet with one of our experts that can help you with your specific needs and goals.

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The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

1. Burbank, Kelton M., et al. “Chronic Shoulder Pain: Part Ii. Treatment.” American Family Physician, 15 Feb. 2008,
2. Koutures, Dr. “Kids Shoulder Pain: 3 Ways to Fix.” Orange County Pediatric and Sports Medicine Practice, ActiveKidMD, 15 May 2020,
3. Bahire, Evelyne. “Tendinopathy.” Physiopedia,
4. Hecht, Marjorie. “Tendinopathy: Definition, Comparison to Tendonitis, and Treatment.” Healthline, Healthline Media, 8 Nov. 2018,
5. Pathak, Neha. “Rotator Cuff Tendinopathy:Symptoms, DIAGNOSIS, TREATMENT.” WebMD, WebMD, 15 Sept. 2020,

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About the Author:
Shelia Tenny is an Occupational Therapist and Certified Hand Therapist. She is passionate about helping those with hand, wrist, elbow, and shoulder pain, including arthritis, sprains, strains, fractures, tendon, and nerve injuries. Sheila has certifications in ergonomic assessments in the workplace and ASTYM, which uses specialized handheld tools to manipulate soft tissue to facilitate healing and tissue regeneration.

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