Written By: Chloe Wilson BSc (Hons) Physiotherapy
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.
We are going to start by looking at the six most common causes of front shoulder pain, what causes them and the typical symptoms associated with them. We will then go on to look at the best treatment options for these causes of pain on the front of your shoulder.
Damage to one of the main stabilising muscles of the shoulder
Causes: Acute injury e.g. heavy lifting, chronic degeneration from repetitive overhead movements or friction from bone spurs
Symptoms: Deep dull ache inside the shoulder and weakness with lifting & twisting
Find Out More: Torn Rotator Cuff
Narrowing of the bony gap in the shoulder causes damage and inflammation in the soft tissues
Causes: Bone spurs, muscle imbalance, friction from repetitive movements and overuse
Symptoms: Sharp, toothache type painful arc, weakness and restricted movement
Find Out More: Shoulder Impingement
Inflammation, thickening or tearing where the biceps tendon attaches to the front of the shoulder
Causes: Repetitive overhead activities, sudden increase in shoulder use, aging or heavy lifting
Symptoms: Deep, throbbing pain in front of shoulder, often worse at night, snapping sensation and tenderness to touch
Find Out More: Biceps Tendonitis
Thickening and scarring of the joint capsule, particularly prevalent in women aged 40-70
Causes: Shoulder injury or surgery, certain medical conditions e.g. diabetes, age and gender
Symptoms: Phase 1: worsening pain. Phase 2: pain improves but movement more restricted. Phase 3: gradual easing of symptoms.
Find Out More: Frozen Shoulder
Damage to the ring of cartilage found on the shoulder socket, the labrum
Causes: Fall, heavy lifting, repetitive overhead activities e.g. throwing or racket sports or shoulder dislocation
Symptoms: Dull aching pain at front of shoulder, instability, difficulty throwing and restricted arm movement
Find Out More: SLAP Tears
A break in the collar bone at the front of the shoulder, common in children
Causes: Falling sideways or onto outstretched arm, RTA, during birth or a direct blow
Symptoms: Visible deformity, sharp front shoulder pain, snapping noise, decreased movement and sensation
Full Article: Clavicle Fractures
We have looked at the most common front shoulder pain causes, but there are a few other things it could be.
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
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.
Let’s look a bit more closely at some of the distinctive features with the different causes of front shoulder pain
Front Shoulder Pain When Lifting Arm: Almost all shoulder problems can cause pain in front of the shoulder 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 or rotator cuff tear
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.
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 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. 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.
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.
Page Last Updated: 30/06/2021
Next Review Due: 30/06/2023