Shoulder Tightness and Pain Part 3:Exercise

This final part of our shoulder series ties together the effects of desk posture, stress, and now exercise — three of the most common factors contributing to shoulder pain and tightness.

Many of us spend our days sitting at a desk or carrying mental stress, then head straight to the gym or out for a run. It’s a pattern that seems healthy on the surface — but if your posture and muscle balance are already compromised, exercise can quickly expose weak links in your shoulder mechanics.

Understanding the Shoulder Joint: Mobility vs. Stability

Let’s start with the basics.

Your shoulder joint, like your hip, is a ball-and-socket joint. But unlike the hip — which has a deep, stable socket — the shoulder has a shallow socket and a large ball.

This structure allows for exceptional mobility (think reaching, throwing, and lifting overhead) but comes at the cost of stability.

To stay secure and move smoothly, your shoulder relies on:

• The labrum (a cartilage ring that deepens the socket)

• Ligaments that provide passive stability

• The rotator cuff muscles, which dynamically hold the ball in place and guide shoulder movement

When any of these supporting structures are overloaded or imbalanced, shoulder pain, impingement, or instability can develop.

How Posture and Stress Affect Shoulder Mechanics During Exercise

The two lifestyle factors explored in the previous blogs — poor desk posture and stress-related tension — can significantly affect how your shoulders move and bear load during exercise.

Here’s how:

1. Rounded Shoulder Posture:
   Hours at a desk cause your chest muscles and the front of your neck to shorten, pulling your shoulders forward.

2. Elevated Shoulder Blades:
   Stress and tension keep your upper trapezius and levator scapulae tight, lifting your shoulder blades toward your ears.

3. Inhibited Rotator Cuff and Scapular Muscles:
   These compensations reduce the activation of key stabilisers like your lower trapezius, serratus anterior, and rotator cuff muscles — all vital for shoulder control during movement.

When you exercise in this compromised position, especially with repetitive or overhead movements (bench press, push-ups, shoulder press, swimming, etc.), you increase the likelihood of:

• Shoulder impingement

• Rotator cuff irritation

• Neck and upper back tension

• Referred pain into the arms

How Osteopathy Can Help Restore Shoulder Function

A South Yarra osteopath can identify the postural and mechanical imbalances contributing to shoulder strain and help restore proper alignment and movement before you even pick up a weight.

Osteopathic treatment for shoulder pain typically involves:

• Soft tissue techniques to release tight chest, shoulder, and neck muscles

• Joint mobilisation and manipulation to improve thoracic and shoulder mobility

• Rehabilitation exercises to strengthen and retrain the rotator cuff and scapular stabilisers

• Postural and ergonomic advice to support proper alignment at work and during training

This comprehensive approach not only relieves pain but improves how your shoulders perform in daily life and exercise, helping to prevent future injuries.

Practical Examples with Visual Demonstrations

Shoulders Down and Back

Shoulders Rolled/Slouched Forwards

Above: Many people have a slouched or rounded mid-back and their sternum sinks down into their pants (metaphorically speaking). As the shoulder joint attaches to the spine, the posture of the spine will affect the position and orientation of the shoulder.

Chest Up and Out, Chin Tucked In

Chest Sunk Into Pants, Chin Jutting Forward

Below: As a physical representation for you - stand up, slouch forward, allowing your sternum to sink into your pants and roll your shoulders forward slightly. Now try and lift your arms out to the side and up above your head so that the backs of your hands touch at the top. What you will feel is that your shoulders tend to jam up, become blocked or perhaps tight over the top once you get just past 90 degrees. This is because tissues within that shoulder joint capsule are becoming pinched between the bony structures. Not only is this uncomfortable and limiting at the time, it also leads to tendon irritation, bursitis and tears in the labrum.

Optimal Starting Position

Free Shoulder Movement

Slouched Starting Position

Limited Range of Motion/Shoulder Impingement

Performing repetitive overhead activities with this poor mid-back and shoulder posture will do you a bother in the long term if these mechanics are not corrected. These tissues also have quite a slow healing time so it’s best to get on top of these issues sooner rather than later.

So, lets fix it together.

Before engaging in exercises that involve the shoulders (most weight training) you should try and mobilise your mid-back. I wont go into detail but rolling on a foam roller, laying back over a swiss ball or doing some rotation stretches will help.

On the topic of spinal organisation - the first thing you should do before performing ANY exercise is organise your spine. That is, make sure your spine is in a neutral posture (not slouched forward or extended backward). So stand up with your chest up and out, being mindful to keep a neutral pelvic position.

Neutral Pelvis and Spinal Alignment

Anterior (Forward) Pelvic Tilt

Posterior (Backward) Pelvic Tilt

Next up, represented in the images below, orient your shoulders correctly in the socket. You can do this but ensuring your shoulders are positioned down and back. This will engage the muscles of your shoulder blades which will allow for safe and smooth movement throughout the range. This is demonstrated in the image below in the hanging position before beginning a pull up. Try and squeeze the muscles between your shoulder blades like you’re trying to draw them down and toward your spine. These muscles should be engaged but not tense, so don’t squeeze with all your might.

Dead Hang/Poor Position to Engage Pull Up Action

Scapular Muscles Engaged, Ready to Initiate Pull Up Action

Now that we have covered organisation we can progress to the movement phase which is demonstrated below. When moving the weight through a range of motion you should try and avoid letting your shoulders raise up around your ears. This applies to almost all exercises except probably Olympic Weight Lifting which requires your to shrug your shoulders up in order to move a weight from below your knees to up above your head.

Bad Finishing Position (Shoulders Shrugged Up)

Good Finishing Position (Shoulders Locked Down and Back)

Poor Finishing Position (Shoulders Shrugged)

Good Finishing Position (Shoulders Engaged)

Key Takeaway

If you think you may be suffering with shoulder impingement, bursitis, upper shoulder tightness and discomfort or restricted shoulder mobility when exercising or in activities of daily living such as hanging washing on the line, wiping benches, or lifting things up onto shelves it is best to have your posture and shoulder mechanics assessed by your Osteopath. They will educate you on how to correct your spinal posture, provide you with hands on treatment during the session and prescribe any stretches or exercises to do at home or in the gym that will assist you in the long term.

What Now?

If you’re experiencing shoulder or neck discomfort during exercise, our experienced South Yarra osteopaths at Osteopathic Movement can help. We provide personalised assessments and hands-on care in our Osteopathic Movement wellness centre. Book your appointment online to improve your shoulder function and move pain-free.

Written by Dr Dayne Sweres (B.AppSci (CompMed), M.Osteo) – Founder, Osteopathic Movement, South Yarra.