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Front Shoulder Pain
Written By: Chloe Wilson BSc (Hons) Physiotherapy
Reviewed By: SPE Medical Review Board
Front shoulder pain, aka anterior shoulder pain, is a common problem.
It may come on gradually over time or suddenly after an injury.
There may be a general dull ache or a specific sharp pain in front of the shoulder and movement may be restricted. Sometimes the pain is linked to a specific activity such as reaching above your head, other times it may seem random.
Pain on the front of the shoulder may extend down the arm too and there may be associated symptoms such as tingling or numbness. But how do you know what is wrong? Let’s look at what causes front shoulder pain.
Causes Of Front Shoulder Pain
There are a number of different things that can cause front shoulder pain and they all present slightly differently. They may involve the shoulder muscles, one of the shoulder joints or other soft tissues.
Here you'll find a brief overview of each one and from there you can find out more about the treatment and recovery process for each.
1. Rotator Cuff Tear
One of the most common causes of front shoulder pain is a rotator cuff tear. This is where there is damage to one of the main stabilising muscles of the shoulder
Rotator cuff tears may be caused by an acute injury e.g. heavy lifting, chronic degeneration e.g. from repetitive overhead movements, or friction e.g. from bone spurs.
Typical symptoms of rotator cuff tears include a deep dull ache inside the shoulder and weakness with lifting & twisting. There may also be a sharp catching sensation with front shoulder pain when using the upper arm.
You can find out all about the common causes, symptoms, diagnosis and treatment options for this cause of anterior shoulder pain in the Torn Rotator Cuff section.
2. Shoulder Impingement Syndrome
Another common cause of anterior shoulder pain is shoulder impingement syndrome.
With shoulder impingement there is narrowing of the bony gap in the shoulder causes damage and inflammation in the soft tissues, resulting in conditions such as rotator cuff tendonitis and shoulder bursitis, most typically subacromial bursitis.
There are a number of things that can cause front shoulder pain from impingement including bone spurs, muscle imbalance, friction from repetitive movements and overuse
Common symptoms of shoulder impingement include a sharp, toothache type pain at the front of the shoulder, a painful arc with shoulder movement, weakness and restricted movement.
You can find out all about front shoulder pain from impingement including the causes, symptoms and best treatment options in the Shoulder Impingement section.
3. Biceps Tendinopathy
Another possible cause of front shoulder pain is biceps tendonitis.
With biceps tendonitis there is inflammation, thickening or tearing where the biceps tendon attaches to the front of the shoulder
Biceps tendonitis is usually caused by repetitive overhead activities, a sudden increase in shoulder use, aging or heavy lifting.
Typical symptoms of biceps tendonitis include a deep, throbbing pain in front of shoulder, often worse at night, a snapping sensation with arm movements and tenderness to touch.
You can find out all about how to treat this cause of front shoulder pain in the Biceps Tendonitis section.
4. Frozen Shoulder
Frozen shoulder is a common cause of front shoulder pain, particularly prevalent in women aged 40-70.
With a frozen shoulder, there is thickening and scarring of the joint capsule, aka adhesive capsulitis.
Often the underlying cause of a frozen shoulder is unknown but they are associated with shoulder injuries or surgery, certain medical conditions e.g. diabetes, age and gender
There are three phases with frozen shoulder. Phase 1: worsening of front shoulder pain. Phase 2: pain improves but movement more restricted. Phase 3: gradual easing of symptoms.
You can find out all about how adhesive capsulitis causes front shoulder pain and how to treat it in the Frozen Shoulder section.
5. SLAP Tear
One of the less common causes of front shoulder pain is a SLAP tear.
With a SLAP tear there is damage to the ring of cartilage found on the shoulder socket, the labrum
SLAP tears are usually caused by a fall, heavy lifting, repetitive overhead activities e.g. throwing or racket sports or shoulder dislocation
Typical symptoms of a SLAP tear include Dull aching pain at front of shoulder, instability, difficulty throwing and restricted arm movement
You can find out all about how to reduce anterior shoulder pain from labrum tears in the SLAP Tear section.
6. Fractured Clavicle
One of the most common causes of front shoulder pain in children is a fractured clavicle.
This is when there is a break in the collar bone at the front of the shoulder.
Clavicle fractures are usually caused by falling sideways or onto outstretched arm, an RTA, or a direct blow to the shoulder, but can also occur during birth
With clavicle fractures there is often a visible deformity, sharp front shoulder pain, a snapping noise with arm movements, decreased movement and sensation.
You can find out all about the causes, symptoms and treatment options in the Clavicle Fractures section.
7. Swimmers Shoulder
Swimmers shoulder is the most common injury seen in swimmers and causes front shoulder pain.
Swimmers shoulder may develop due to incorrect stroke technique, muscle imbalance or overuse, particularly if you suddenly increase your training.
Typical symptoms of swimmers shoulder include deep aching front shoulder pain, weakness and fatigue and joint laxity.
You can find out how to treat this cause of front shoulder pain in the Swimmers Shoulder section.
Other Possible Causes
We have looked at the most common front shoulder pain causes, but there are a few other things it could be.
ACJ Injury
Damage to the bones or ligaments at the acromioclavicular joint (ACJ) causes front shoulder pain where the scapula meets the clavicle. ACJ injuries may develop gradually overtime due to wear and tear or suddenly due to an injury such as a fall onto the shoulder. Most ACJ injuries will heal naturally in a few weeks but more severe injuries may require surgery
Dislocated Shoulder
A shoulder dislocation is where the round head at the top of the upper arm bone gets pushed out of its socket on the shoulder blade. This is normally caused by a fall or a direct blow to the shoulder, causing immediate pain and an obvious deformity at the front of the shoulder. A dislocated shoulder requires immediate medical attention.
Osteoarthritis
Gradual wear and tear and degeneration of the shoulder cartilage can lead to restricted movement, particularly rotation and front shoulder pain. Conservative treatment such as physiotherapy and pain relief are often sufficient but is symptoms get progressively worse, then surgery may be indicated.
Why Does The Front Of My Shoulder Hurt?
There are lots of different things that can cause front shoulder pain but by thinking about your specific symptoms it can be easier to work out what is going on:
- Front Shoulder Pain When Lifting Arm: Almost all shoulder problems can cause front shoulder pain when lifting the arm, but it tends to vary which part of movement is the most painful
Worse With Initial Movement: Tendonitis, SLAP Tear, Frozen Shoulder
Worse When Arm Around Shoulder Height: impingement syndrome, rotator cuff tear, swimmers shoulder or subacromial bursitis
Worse When Arm Fully Raised: Rotator Cuff tear, biceps tendonitis, osteoarthritis, ACJ injury - Pain In Front Of Shoulder When Throwing: front shoulder pain when throwing things is common as the shoulder is in its most vulnerable position when the arm is working around shoulder height. Common causes include a SLAP tear, rotator cuff tear, biceps tendonitis or shoulder impingement syndrome
- Sharp Pain In Front Of Shoulder: If there is a sharp pain in front of the shoulder it may indicate that something is getting trapped or pinched with shoulder impingement syndrome. Or if you’ve injured the front of the shoulder it may indicate a fractured collarbone
- Dull Pain In Front Of Shoulder: If the pain in front of your shoulder is more or a dull pain than a sharp one, you may have a rotator cuff tear, SLAP tear, swimmers shoulder or frozen shoulder
- Burning Pain In Front Of Shoulder: If your main symptoms is a burning sensation at the front of your shoulder it is most likely a sign of bursitis, biceps tendonitis or nerve damage
- Pain In Front Of Shoulder And Down Arm: If your shoulder pain extends down your arm, particularly below the elbow then it is likely to be due to nerve damage or referred pain from the neck rather than a problem in the shoulder itself
- Pain In Front Of Shoulder When Breathing: Front shoulder pain that gets worse when you breathe is unlikely to be problem in the shoulder itself, but is more likely to be a medical issue such as angina, pleurisy or even a heart attack. If you get shoulder pain when breathing get checked out by your doctor asap as there could be a serious problem
- Front Shoulder Pain When Benching: If you are getting pain when you bench press it may simply be that you need to look at your technique or that there is some muscle imbalance with weakness or tightness around your shoulder. Another possibility is a rotator cuff tear which may have been caused by overloading the tendon
- Painful Arc With Shoulder Movement: Front shoulder pain that is worse when the shoulder is lifted around shoulder height or anywhere in the arc 30 degrees above and below that is usually due to shoulder impingement syndrome, subacromial bursitis or supraspinatus tendonitis. Outside the range there is often little pain
- Severely Restricted Shoulder Movements: If your arm movements are severely restricted and you have suffered an injury such as a fall, then you may have a shoulder fracture or a dislocated shoulder. If your arm movement has gradually become more and more restricted, particularly twisting movements, with or without pain, then you may have a frozen shoulder, particularly if you are over 40.
Front Shoulder Pain Treatment
The best treatment for front shoulder pain will depend on the underlying cause but will usually involve a combination of:
- Rest: from aggravating activities to allow the shoulder to heal
- Ice: to reduce inflammation using ice packs
- Medications: to reduce pain and inflammation
- Exercises: to strength, stretch and improve shoulder mobility and control
- Physical Therapy: targetted rehab program which may involve some hands-on treatment such as deep transverse friction massage, electrotherapy and taping
- Surgery: if your front shoulder pain fails to settle with conservative treatment or with more serious injuries, then surgery may be recommended.
You can find out about the best ways to treat the different causes of front shoulder pain in the following articles
- Rotator Cuff Tear Exercises
- Shoulder Impingement Exercises
- Biceps Tendonitis Treatment
- Frozen Shoulder Exercises
- SLAP Tear Treatment
- Collar Bone Injury Treatment
- Swimmers Shoulder Treatment
- Dislocated Shoulder Treatment
- Subacromial Bursitis Treatment
What Else Can Help?
You can find out loads more about each of these causes of front shoulder pain, including what the best treatment options are for each by using the links above.
In most cases, front shoulder pain will settle down with a combination or rest, medication, physical therapy and rehab exercises. However, sometime surgery will be needed to remove abnormal bone growths or repair torn soft tissues.
If you have pain elsewhere in your shoulder or arm, visit the shoulder pain diagnosis section for help working out what is wrong.
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Page Last Updated: November 5th, 2024
Next Review Due: November 5th, 2026
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