Shoulder Pain

Caused by Onset
of Stress –
Treatment &
Prevention
BY: J. LEVINE
ELECTRONICS TECHNOLOGY
 Overview

▪ Chief Complaint: Severe pain in shoulder blade with onset of stress

as well as random flareups when not stressed.

▪ The cause appears to be stress & not an underlying condition at

this time
 Note:

▪ These recommendations are based on what you have told me, and
may not be accurate if you didn’t tell me something
▪ The only reason I am recommending exercising is because from
what you have told me, there is no indication of an underlying
condition/injury & the pain is caused solely by stress
▪ If there is any doubt there may be an underlying condition/injury
causing the pain, do not do any of the exercises & talk to me so I can
adjust accordingly
▪ This is crucial as it can make it worse & cause more pain
 Causes

▪ Shoulder tightness that ultimately results in pain can be caused

by:
▪ Improper posture
▪ Prolonged sitting
▪ Using improperly positioned computer
▪ Overuse of phone
▪ Stress
▪ Carrying heavy things
▪ Injuries
▪ Arthritis
▪ Etc.
▪ Shoulder tightness also worsens with age so it's better to try and
correct it now before it gets worse.
 Options (Brief Overview)

▪ “Exercise” (approx. 6-12 weeks)

▪ Hot/Cold Therapy
▪ Misc. (Things not big enough for their own section so I just put
them into their own mini-section)
Option 1:
“Exercise”
 Tips/Guidelines

▪ Muscles shorten over time when they aren't often used, the same
is true with the shoulders, which are also muscles. Stretching fixes
this shortening, making them more flexible.
▪ Do these exercises 3-6 times per week
▪ Start with 10-minute sessions & gradually increase duration
▪ Don't overdo it, don't try and push yourself that much
▪ If you start feeling pain, stop as this means your body needs a
break
▪ Apply heat compress to reduce stiffness before exercising & apply
a cold compress after to reduce inflammation.
 Benefits

▪ Shoulder stretches can:

▪ Reduce tension
▪ Relieve pain
▪ Increase range of motion (mobility)
▪ Reduce risk of injury
▪ Improve posture
▪ Plus, so much more!
 Neck Stretches

1. Stand with feet hip-width apart

2. Let arms hang down by the sides
3. Look forward
4. Tip head to the right, trying to touch the right ear
to the right shoulder
5. Feel the stretch in the right side of the neck &
shoulder
6. Tip head to the left, trying to touch the left ear to
the left shoulder
7. Each time, hold position for 10 seconds
8. Repeat this 3 times on each side
 Shoulder Raises

1. While standing/sitting, & with arms by your

side & a straight back, slowly lift your
shoulders up toward ears
2. Hold
3. Slowly lower shoulders back down
4. Repeat 5 times
 Shoulder Rolls

1. Stand/sit with feet hip-width apart (maintain

good posture)
2. Let arms hang down at the sides of the body
3. Breathe in and lift the shoulders up to toward
ears
4. Move the shoulders back, squeezing the
shoulder blades together
5. Exhale & drop the shoulders back
6. Move the elbows forward, feeling the stretch
at the back of
7. Repeat this 10 times
 Ear to Shoulder

1. Sit with a straight spine & tilt your head

toward right shoulder
2. Go as far as you can without straining or
lifting your left shoulder
3. Deepen the stretch by using your right hand to
gently pull your head down
4. Hold for 30 seconds
5. Repeat on opposite side
 Chin Retraction

1. Align head, neck, & spine while

standing/sitting
2. Extend your chin in front of you as far as it will
go without straining
3. Pull your chin back into throat & neck
4. Repeat 10 times
 Cross Arm Stretch

1. Bring your left arm across the front of your

body at about chest height
2. Support left arm with the elbow crease of your
right arm or use right hand to hold left arm
3. Stretch out shoulder & continue to face
forward
4. Hold
5. Repeat on opposite side
 Standing Arm Swings

1. Stand with arms by side & palms facing body

2. Swing arms forward to bring arms as high up
as they will go without raising shoulders
3. Lower arms back down & bring them as far
back as you can
4. Keep rest of body still
5. Continue for 1 minute
 Standing Arm Lifts

1. Make fists with hands & bring in front of hips

2. Inhale as lifting arms forward to bring arms
overhead so your hands com together above
your head
3. Lower back down to original position
4. Repeat 10 times
 Wide-Legged Standing Forward Bend

1. Stand with feet wider than hip distance with

toes facing forward
2. Interlace your hands behind back & open
your chest
3. Engage leg muscles & keep a slight bend in
knees
4. Hinge at the hips to fold forward, bringing
arms over head toward the floor
5. Allow head to hang down & tuck chin in
slightly to chest
6. Hold for 1 minute
 Cat Cow Pose

1. Get down on knees

2. Place hands underneath shoulders & knees
underneath hips
3. On inhale, fill your belly with air & let it sink
down as you look up
4. Exhale as you engage your abdominals, tuck
chin into chest, & round spine
5. Hold for a few minutes, paying special
attention to shoulders
 Thread The Needle

1. Remain on all fours with hands directly under your

shoulders & knees underneath hips
2. Lift right hand & slowly bring it over to the left with
palm facing up
3. Rest your body on right shoulder & turn head to
face left
4. Make sure you’re not sinking onto your shoulder
5. Hold for 30 seconds
6. Slowly release and come back to original position
7. Repeat on opposite side
 Reverse Prayer Pose

This can be done while sitting/standing

1. Bring hands behind back with the backs of
hands facing each other & fingers facing
down
2. Flip hands in other direction so fingers are
facing up
3. Turn palms to face each other
4. Press palms together, draw elbows slightly
back, & open chest
5. Keep spine straight
6. Hold for 30 seconds
 Cow Face Pose

This can be done standing or sitting

1. Bring left elbow up to side of head with hand
facing down spine
2. Use right hand to draw left elbow over to the
right as hand moves further down spine
3. If it’s comfortable, bend right arm & bring
right hand up to clasp left hand
4. Hold for 1 minute
5. Repeat on opposite side
 Across-the-Chest Stretch

1. Bring right arm across chest

2. Place it in the crease of left elbow or use left
hand to support arm
3. Hold for up to 1 minute
4. Repeat on opposite side
5. Do each side 3-5 times
To deepen this stretch, lift arm to shoulder height
 Neck Release

1. Lower chin toward chest (feel a stretch along

the back of neck)
2. Gently tilt head to the left to stretch right
shoulder
3. Hold for up to a minute
4. Repeat on opposite side
5. Do each side 3-5 times
 Eagle Arms Spinal Rolls

1. While seated, extend arms out to sides

2. Cross elbows in front of body with right arm on top
3. Bend elbows, placing the backs of forearms &
hands together
4. Reach right hand around to bring palms together
5. Hold for 15 seconds
6. On an exhale, roll spine while drawing elbows in
toward chest
7. On an inhale, open chest and lift arms
8. Hold for 1 minute
9. Repeat on opposite side
 Seated Twist

1. Sit in a chair with ankles directly under knees

2. Twist upper body to the right, bringing the
back of left hand to thigh
3. Place right hand wherever it’s comfortable
4. Hold for up to 30 seconds
5. Repeat on left side
6. Repeat 3-5 times on each side
 Shoulder Circles

1. Stand with left hand on back of chair

2. Allow right hand to hang down
3. Circle right hand 5 times in each direction
4. Repeat on the opposite side
5. Do this 2-3 times per day
 Downward Dog Pose

1. Start on hands & knees

2. Press into hands to lift hips up toward the
ceiling
3. Maintain a slight bend in knees while pressing
your weight evenly into your hands & feet
4. Keeping spine straight, bring head toward feet
so that shoulders are flexed overhead
5. Hold for up to 1 minute
 Child’s Pose

1. From Downward Dog Pose, bring big toes

together & knees slightly wider than hips
2. Sink hips into heals & extend arms in front
3. Allow chest to fall heavy toward the floor,
relaxing spine & shoulders
4. Hold for up to 5 minutes
 Doorway Shoulder Stretch

1. Stand in a doorway with elbows & arms

forming a 90-degree angle
2. Step right foot forward while pressing palms
into sides of door frame
3. Lean forward & engage the core
4. Hold for up to 30 seconds
5. Repeat with left foot forward
6. Do each side 2-3 times
 Cross-Body Arm Swings

1. Stand with feet hip-width apart

2. Inhale & lift arms out to the sides, squeezing
shoulder blades together
3. Exhale & gently bring arms in toward each other
4. Cross the right arm under the left, keeping both
arms straight
5. Inhale & gently swing arms back out to sides,
squeezing shoulder blades together
6. Exhale & gently bring arms in toward each other
again
7. This time, cross the left arm under the right,
keeping both arms straight
8. Repeat 10 times
 Cross-Body Shoulder Stretch

1. Stand with feet hip-width apart

2. Stretch right arm out straight
3. Bring right arm across the body, so the hand
points to the floor on other side of left leg
4. Bend left arm at elbow
5. Hook left forearm under right arm, supporting
right arm above elbow
6. Use left forearm to pull right arm further in &
across body, stretching the back of right
shoulder
7. Hold for 20 seconds & repeat on other side
 Ragdoll Pose

1. Stand with feet hip-width apart

2. Bend knees slightly
3. Bend forward & try to touch toes
4. Keep the stomach against the bent knees to
support lower back
5. Place each hand on elbow of the opposite arm
6. Crown of head should point toward floor
7. Let head hang heavily, releasing tension in
neck & shoulders
8. Hold for at least 1 minute
 Eagle Arm Stretch

1. Stand with feet hip-width apart

2. Inhale & lift arms to sides
3. Exhale & swing arms toward body
4. Allow right arm to cross under left
5. Cradle left elbow in crease of right elbow
6. Bring palms together if they reach
7. If palms aren’t touching, hold backs of hands
together
8. Take 3-4 deep breaths
9. Release & repeat on other side, with left arm
crossed under right
 Side-Lying Thoracic Rotation

1. Lay on right side on ground/mat

2. Bend knees slightly
3. Stretch right arm straight ahead
4. Place left hand on top of the right
5. Keep staring at left hand
6. Reach left hand straight up
7. Rotate left arm toward floor behind the back, as
if drawing an arch in the air
8. Keep knees & hips pointing to right throughout
9. Bring left arm back over to meet the right
10. Repeat several times
11. Repeat on opposite side
 Option 2:
Heat/Cold Therapy
 Hot/Cold Therapy

▪ When in pain, apply hot/cold compress

▪ DO NOT put compress directly on skin, wrap it in something so
there is a barrier between the compress and your skin
Misc.
 RICE Acronym

▪ The RICE acronym stands for:

▪ Resting
▪ Icing
▪ Compressing
▪ Elevation
▪ In addition to the RICE method, you can use a heating pad and/or
take a bath with Epsom salt.
 Additional Pain-Relief

▪ Take N-SAID pain relievers when in pain

▪ In addition to or in replacement of pain medicine you can apply a
menthol rub a few times a day to the affected area(s).
That quote from the previous slide leads to an
important saying in the medical world:
 Meaning…

▪ We believe that your pain is being caused by stress

▪ Therefore, the best way to treat the pain is by preventing the stress
that is causing the pain to begin with
▪ Or at the very least reduce & manage it
 Steps to Stress Management

1. Identify causes/triggers of your stress

2. Work on reducing them, and ways to cope with them
3. Talk to someone about them – even if the problem won’t be solved
1. It will help, I promise
▪ There is a lot more to stress management than you think, it involves a lot
of worksheets/workbooks, talking, etc. I would be more than happy to do
it with you. (I already have it done, but it’s a bit much to put in this
PowerPoint)
▪ Just like the exercising, this will also require a time commitment, not a
large one though
▪ I was thinking maybe an hour a week or something like that (maybe meeting
with me so I could kind of guide you through it)
 Review

▪ Heat compress before exercise

▪ Exercises
▪ 3-6 times/week
▪ Start with 10 minutes & gradually increase duration
▪ Cold compress after exercises
▪ Menthol rub – As needed
▪ Pain medicine – As needed
▪ Prevention – Stress reduction
 Works Cited

▪ “4 Stretches to Keep Your Shoulders in Shape.” Harvard Health Letter, vol. 44, no. 10, Aug. 2019, p. 6.
EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=m
fi&AN=137652996&site=ehost-live&scope=site.
▪ “Don’t Shrug off Shoulder Pain.” Harvard Health Letter, vol. 42, no. 10, Aug. 2017, p. 6. EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=h
xh&AN=123921534&site=ehost-live&scope=site.
▪ “Easing Shoulder Pain.” Consumer Reports on Health, vol. 23, no. 3, Mar. 2011, p. 10. EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=f5
h&AN=57949458&site=ehost-live&scope=site.
▪ “Keep Your Shoulders Strong to Stay Independent.” Harvard Health Letter, vol. 41, no. 2, Dec. 2015, p.
4. EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=h
xh&AN=111114761&site=ehost-live&scope=site.
▪ Shaffer, Alyssa. “Stretches You Should Be Doing (But Aren’t).” Health, vol. 30, no. 2, Mar. 2016, pp.
47–49. EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=h
xh&AN=112811694&site=ehost-live&scope=site.
 Works Cited Cont.

▪ “Shoulder Pain: Nothing to Shrug At.” Harvard Men’s Health Watch, vol. 6, no. 12, July 2002, p. 3.
EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=m
fi&AN=6810068&site=ehost-live&scope=site.
▪ “Shoulder Pain? Here’s What You Can Do to Treat It and Prevent It.” Harvard Women’s Health Watch,
vol. 22, no. 10, June 2015, p. 5. EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=h
xh&AN=102958771&site=ehost-live&scope=site.
▪ “Shoulder Shape-up: Keep Your Body’s Most Flexible Joint in Top Condition.” Harvard Men’s Health
Watch, vol. 18, no. 7, Feb. 2014, p. 5. EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=h
xh&AN=94282413&site=ehost-live&scope=site.
▪ “Shouldering Too Much?” Consumer Reports on Health, vol. 15, no. 9, Sept. 2003, p. 7. EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=f5
h&AN=10473371&site=ehost-live&scope=site.
▪ “Tight Shoulders: 12 Stretches for Fast Relief ... - Healthline.” HealthLine,
www.healthline.com/health/tight-shoulders.
 Works Cited Cont.

▪ Top 10 Exercises to Relieve Shoulder Pain and ... - Healthline.

www.healthline.com/health/shoulder-pain-exercises.
▪ “Top 10 Shoulder Stretches for Pain and Tightness.” Medical News Today, MediLexicon International,
www.medicalnewstoday.com/articles/324647.
▪ WOODS, JEFFREY M., and SUSAN DAWSON-COOK. “The Shoulder Complex.” American Fitness, vol.
31, no. 2, Mar. 2013, pp. 24–30. EBSCOhost,
www.search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid&custid=csl&db=f5
h&AN=85691434&site=ehost-live&scope=site.