Expert advice for identifying, alleviating, and preventing the most common causes of this pesky issue.
When I first started running about seven years ago, my shoulders would randomly throb midworkout. The shoulder pain while running was definitely annoying (and on occasion, pretty excruciating), but it dissipated the more I ran, so I didn’t think much of it. Yet over the years, that sore sensation has sporadically returned. A recent run left my shoulders burning more than my quads, making me wonder, What is going on here?
Turns out, I’m not the only runner plagued and confused by sore shoulders. Elizabeth Lamontagne, D.P.T., S.C.S., C.K.T.P., assistant director and physical therapist at Recovery Physical Therapy in New York City, says about half of the runners she sees experience shoulder pain.
Shoulder pain while running can show up in different regions of the shoulder muscle group, including the upper trapezius (a muscle that attaches to the neck, shoulders, spine, and base of the skull), deltoids (sides of the shoulders), or rotator cuff (muscles and tendons surrounding the shoulder joint). The sport is a “very dynamic form of exercise” that relies on many different muscle groups, including the shoulders, neck, and upper back, explains Ramon Julian M. Pesigan, M.D., assistant professor at Mount Sinai Health System and primary care and sports medicine specialist at the Samuel J. Friedman Center for the Performing Arts in New York City.
While these upper-body muscles are not the main drivers in running, they do play an important role in helping us run with good posture. And running with good posture—shoulder blades back and down, chest up, eyes forward, neck in line with your spine—maximises the efficiency of your stride and reduces your risk of injury. For a variety of reasons, your upper body muscles—including the shoulders—can ache during a run.
Here, we dig into why you may experience shoulder pain while running, and also share expert tips for alleviating and preventing this irksome issue.
9 Common Causes of Shoulder Pain
1. You recently started running, or you recently upped your mileage.
Any time you start a new activity—or dial up the intensity of a current activity—your body is going to feel the effects of that change as it works to adapt to the increased demands. Think back on your training the past seven days. If you have started running after a long hiatus, or suddenly bumped up your K’s, all the muscles involved in running, including your shoulders, are going to take on extra stress and pain at first, says Dean Somerset, C.S.C.S., kinesiologist, and exercise physiologist.
How to treat it:
Ice sore areas for 20 minutes, wait one to two hours, and then ice again if needed, advises certified exercise physiologist DeAnne Davis Brooks, Ed.D., C.S.C.S., an associate professor in the department of kinesiology at the University of North Carolina Greensboro and USATF Level 1 track coach. Stick with your exercise routine, if possible, but if your shoulder soreness is too acute for that, dial back the intensity until your aches subside, which should happen in a week or less. If soreness doesn’t get better in a week, visit an athletic trainer to make sure you’re not dealing with injury, says Brooks.
How to prevent it: Ramp up your training gradually to avoid excessively stressing your shoulders (and the rest of your body).
2. You’re holding too much tension in your upper body.
When runners get tired or try to push the pace, they may inadvertently tense their neck muscles and hike up their shoulders, explains Rajwinder Singh Deu, M.D., assistant professor of orthopaedic surgery at the Johns Hopkins School of Medicine. Other runners may consistently hold extra tension in their upper body as they stride, says Somerset.
In both scenarios, this excess tension can fatigue and tighten the shoulder muscles and lead to shoulder pain. If your shoulder pain is accompanied by jaw and neck pain, that could be a sign you are holding too much tension in your upper body as you run, says Somerset. Another indication, Somerset adds, is if you feel like you can’t move your shoulders while running.
How to treat it: Ice sore areas (start with 20 minutes, wait one to two hours, and then ice again if needed) and if the achiness is severe, reduce the intensity of your running until it subsides. Otherwise, keep training as usual and follow the below tips to prevent the issue from returning.
How to prevent it: As you stride, stay mindful of where you hold tension, says Somerset. If you feel pain creeping into your shoulders, focus on the muscle (or muscles) that hurts, breathe through the discomfort, and then try to relax the area, suggests Brooks.
3. You have poor posture.
All of the experts agreed that poor posture—i.e. rounding your shoulders, hiking your shoulders up toward your ears, and/or leaning your head forward—is a big cause of shoulder pain while running. This improper positioning can cause your upper trapezius and levator scapulae (a neck muscle that connects at the very top of the spine) to take on too much work, explains Brando Lakes, D.P.T., a physical therapist with Orthology in New York City. And when these muscles become overused, they’ll start to ache. Sometimes, poor posture can lead to non-specific pain that radiates, says Lamontagne.
How to treat it:
Again, ice sore areas as needed and dial back your training as appropriate. To truly treat the issue, however, you’ll need to ID—and then correct—your poor posture. You can do the former by filming yourself, or, if you’re passing a storefront, take a quick glance at your reflection, says Lamontagne. Form errors can be tricky to spot though, so you may also want to get evaluated by a running coach or physical therapist to learn exactly what you’re doing wrong—and how to fix it.
This mini stretch break can help you refocus your attention on maintaining good form while also providing a quick reprieve for aching muscles. It’s also important to practice good posture in your day-to-day life, especially now, as many of us spend our days hunched over couch-desks at home. Taking the time to set up an ergonomic workspace can make a “big difference,” says Brooks.
4. Your arm swing is off.
Aggressively swinging your arms across your body as you run could overengage your pectoralis minor (a small chest muscle), says Lakes, as well as your deltoids and rotator cuff, says Somerset. The overuse of these muscles, in turn, could cause shoulder pain.
How to treat it: Bring one arm behind your back, grab it with your other arm, pull down, and tilt your head away from that shoulder to give your deltoids and traps a deep stretch, says Somerset. You can also soothe aching pec minors with a simple doorway stretch from Lakes (see below). Then, work on correcting your arm swing with the below tips.
How to prevent it: Think about running with your elbows at right angles, arms open and relaxed, and loose hands, says Brooks. As you stride, move your shoulders forward and backward—not across your body.
5. Your upper half is weak.
You may have perfect running form, but if your upper body isn’t strong enough to maintain this proper positioning over the course of your run, you’ll likely slip back into ache-inducing habits, like hunching forward, or swinging your arms across your chest, says Brooks.
How to treat it: Your mid-back muscles play an important role in maintaining good running posture. If you struggle to do an inverted row, you probably need to strengthen that area, says Lamontagne. But good running form is about more than just your back, and if you suspect other upper body muscles are subpar in strength, see a PT to pinpoint areas of weakness and develop a plan for strengthening them.
How to prevent it: Incorporate upper body strength training alongside running workouts to build and maintain strength in your upper half. Pesigan suggests doing compound exercises (i.e. moves that work multiple muscles at once) as opposed to isolation exercises (which work just one muscle group at a time), as the former more closely mimics the dynamic movements of running. It’s also a good idea to focus on building strength in muscles that help you maintain proper form while running, like the triceps, biceps, and deltoids, says Lakes, as well as the big muscles of the back, adds Pesigan. Also important: the rotator cuff and muscles surrounding the neck, says Deu.
6. You need new running shoes.
If you’re running on worn-out shoes, the lack of support will change your gait and stride, says Pesigan. Those tweaks in form will travel upwards, potentially causing pain (and sometimes even injury) in your upper half. Check your shoes—are they noticeably worn on the bottom? Is the foam uneven on one side? If yes, that could explain your recent shoulder pain.
How to treat it: Alleviate soreness with easy range of motion exercises, like downward dog, child’s pose, shoulder circles (see below for instructions), and arm raises to the front and sides, suggests Pesgian. You can also ice aching shoulders for about 15 to 20 minutes, he adds. Then, trade your worn shoes for a fresh pair.
How to prevent it: Buy new running shoes well before your current ones fall apart. Running shoes are typically good for 300 to 500 miles, as Runner’s World previously reported.
7. You’re stressed.
Some people hold stress in their neck and shoulders, and even though running can be a great stress-reliever, that tension may not necessarily subside when you lace up, says Brooks.
How to treat it: Take a minute to check in with yourself. Have you been feeling extra worried lately? More anxious than usual? Additional angst could be the cause of your shoulder pain, and if that’s the case, it will persist outside of your workout.
How to prevent it: Do what you can to prioritise your mental health. As mentioned, running can be a powerful tool for managing stress, but make sure you’re running with proper form (see above) so that you don’t accidentally exacerbate your shoulder tightness while you stride, says Brooks.
8. You’re an aggressive heel striker.
If you run with a really harsh heel strike (meaning, your heel is the first thing that hits the pavement with every stride—and it hits hard), the resulting ground shock will go through your body and travel upward to your shoulders, says Somerset. The muscles that hold your shoulders in place will have to contract with every heel strike in order to bear against the ground shock, and that repetitive contraction can lead to fatigue and soreness.
Look at the bottom of your running shoes. If you see a lot of wear around the heel and not much wear anywhere else, you’re likely a heel striker, says Somerset, and this habit could explain your shoulder pain.
How to treat it:
Try shifting your run stride so that your midfoot or forefoot is the first point of contact with the ground, Somerset advises.
How to prevent it: If you’re a known heel striker, ask a specialist at your local running store for help finding shoes that reduce the impact of a heel strike.
9. Your shoulders are too relaxed.
As mentioned, you don’t want to hold too much tension in your shoulders as you stride. But you also don’t want to be too loose, warns Somerset, as that floppiness could cause your shoulders to bounce around with every foot strike and become both stretched and loaded under tension.
How to treat it: Simply rest for a day or two, says Somerset. Any achiness caused by too-relaxed shoulders should subside in that time. Then, follow the below tip to solve the underlying issue.
How to prevent it: Lightly brace your core as you run, suggests Somerset. This can help you draw your shoulders in tight enough against your ribs.
When to see a doctor about shoulder pain
There’s a difference between shoulder pain caused by sore muscles and shoulder pain caused by injury, and it’s important to understand the distinction, says Brooks. If your shoulder pain from running is severe enough that you can’t run or perform day-to-day activities, you should definitely see a medical professional, advise the experts. You should also call your doc or PT if the pain continues despite your best efforts to remedy the underlying cause. And if your pain can be tied to a specific incident, or seems to get worse over time, that’s yet another sign you should get checked out by a pro, Brooks adds.
Stretches to alleviate tight, achy shoulders
If your shoulders hurt from running, it’s important to ID and address the underlying cause so that you can find a long-term solution. It’s also, as mentioned, a good idea to incorporate regular upper-body strength training, as that will increase your capacity to endure a repetitive activity, such as running, says Pesigan.
For quicker relief, however, you can do shoulder stretches to temporarily alleviate tightness caused by running. Here are six great expert-recommended stretches that you can do before a run (just warm up a little bit first so you’re not stretching cold muscles)—or after. Remember stretching should feel gentle; if you feel any pain or discomfort as you do these moves, back off.
Pec Minor Doorway Stretch
How to do it: Stand in front of a doorway and place one elbow and forearm on the doorframe. Position your elbow slightly below shoulder height and draw your shoulder blades together. Slowly take several steps forward through the doorway keeping your elbow and forearm fixed on the doorframe. You will feel a gentle stretch in the front of your chest. Then back up slightly and rotate your body away from the elbow and forearm that are fixed on the doorframe. Stop rotating when you feel a gentle stretch in the area where your chest connects to your shoulder. Hold for 30 seconds; switch sides and repeat.
How to do it: Clasp your hands together behind your back and pull your shoulder blades together and down. Drop your chin to increase the stretch in your traps and then gently rock your head from side to side to stretch the muscle from different angles. Continue for 15 to 30 seconds. Rest and then repeat.
Side Shoulder Stretch
How to do it: Cross your left arm in front of your body and place your right hand on top of your upper left arm. Press against the upper left arm to increase the stretch on the side of your left shoulder. Hold for 15 to 30 seconds. As you stretch, make sure your shoulders stay down (don’t let them hunch up toward your ears). This is one rep. Rest and repeat for another rep. Switch arms and do another 2 reps, resting in between.
How to do it: Stand up tall and reach your right hand in front as if you’re able to shake hands. Over the course of 5 seconds, continue raising your arm overhead, rub your bicep against your ear, and reach your arm behind you as far as you can without letting your arm drift horizontally. Then, reverse the movement over the course of 5 seconds. As you move your arm, you should feel a stretch in the muscles surrounding your shoulder blade. This is one rep. Do 5 total reps. Switch arms and do another 5 reps.
How to do it: Lie on your back with your knees bent, feet flat on the ground. Place a foam roller lengthwise along your spine. Raise your arms straight up, palms facing each other. Then, reach your arms straight back over your head, keeping your elbows straight. You should feel a gentle stretch in your torso and the sides of your armpits. Hold for 60 seconds.
How to do it: Lie on your back with your knees bent, feet flat on the ground. Place a foam roller lengthwise along your spine. Raise your arms straight up and open them horizontally into a T position, palms facing up and arms hovering just above ground level. You should feel a gentle stretch in your chest, biceps, and the front of your shoulders, and possibly in your forearms and wrists. Hold for 60 seconds.
You can also treat achy shoulders with ice (as mentioned) as well as self-massage or a sports massage, says Brooks. Just be careful with sports massages if you’re new to them, she warns—they can be quite forceful and cause additional soreness.