Anterior shoulder pain – or pain in the front of the shoulder – happens when your shoulder joint, muscles, and/or tendons get injured or strained.
It’s more common than posterior shoulder pain (or pain in the back of the shoulder) and it normally occurs as a result of injury to the joint and the resulting inflammation of the tendons attached to it, causing the rotator cuff to be unable to support the glenohumeral joint. This causes pain in the biceps and the front shoulder.
In this guide we’ll discuss the common types of anterior shoulder pain, the causes, and the associated treatments for these issues that range from relatively simple over-the-counter-meds to physiotherapy.
What causes anterior shoulder pain (front shoulder pain)?
Your shoulder joints are composed of five bones – the humerus, the glenoid, the scapula, the acromion, and the clavicle – combined with the muscles and tendons that form your rotator cuff, which is the all-important collection of bones and tissues that keeps your upper arm bone firmly tucked within your shoulder socket.
Injuries to the rotator cuff can cause anything from dull aches and pain and the associated issues with movement to severe pain and even immobility.
When your rotator cuff is injured or inflamed, you can experience anterior shoulder pain. It doesn’t matter how old you are or how active you are, front shoulder pain can hamper your mobility and have a negative effect on your lifestyle. The pain can also be worse at night.
Shoulder injuries like fractures, bone breakage, injured tendons or muscles are the typical causes of anterior shoulder pain. Repetitive strain on the muscles like lifting heavy objects or participating in sports that may strain the shoulder joints is another potential cause, and arthritis symptoms in the shoulder can also result in pain that radiates from the shoulder to the neck.
Immediately assessing how severe these types of injuries are goes a long way towards finding effective treatments, which may range from cold therapy and pain meds to physiotherapy and even shoulder surgery.
The presence of another preexisting health condition like arthritis that causes shoulder soreness can also result in front shoulder pain.
Anterior shoulder pain can be also be the result of high muscle tension at key trigger points.
Common types of anterior shoulder pain include:
- Acromioclavicular Joint Injury – Localized pain in the clavicle caused by the overuse of the shoulder.
- Adhesive Capsulitis – Stiffness in the shoulder joint that can lead to the loss of movement during abduction and external rotation.
- Biceps Tendonitis – When the tendons and muscles are damaged by lifting up and carrying heavy objects.
- Shoulder Impingement Syndrome – When the tendons on your shoulder blade rub together, causing pain in the front of the shoulder.
- Labral Tear – Torn cartilage in the shoulder region, causing deep, severe pain.
- Rotator Cuff Tear or Tendinopathy – An injury causing severe pain when you rotate your shoulder and the general weakening of the tendons in your shoulder joints.
- Shoulder Arthritis – This progressive condition causes pain in the shoulder and surrounding areas and can be at least partially treated by removing the loose fragments of bone cartilage, and other tissue from the shoulder joint.
Symptoms of anterior shoulder pain
Some of the common symptoms of this type of shoulder pain are swelling, tenderness, and pain in front shoulder joint, severe pain and stiffness in the shoulder, a continuous or ongoing feeling of discomfort, decreased strength, and limited mobility of the affected shoulder, including the inability to lift heavier objects or difficulty lowering that arm.
Self-massaging areas that are painful can be a way to start to assess the issue before you can see a medical professional – sensitivity to pressure and pain are a sign that your shoulder muscles are not healthy.
Diagnosing anterior shoulder pain
Determining the cause of anterior shoulder pain can be complicated. It starts with a physical examination in order to check for the signs and symptoms associated with the various types of problems that can cause pain in the front of the shoulder or front delt pain.
X-rays will likely also be performed in order to see a clear image of the condition of your shoulder.
Other physical tests will likely also be ordered in order to determine the extent and severity of your shoulder pain, as well as the range of movement you have with and without pain.
These tests include but are not limited to:
- Dynamic Relocation Test – Examining for potential glenohumeral instability, shoulder dislocation, or subluxation.
- Dynamic Stability Test – Testing the rotator cuff’s ability to maintain the humeral head on the center of the glenoid throughout the rotational arc of the shoulder joint.
- Kinetic Medial Rotation Test – A test used as a way of differentiating between anterior shoulder pain symptoms that could be impingement or instability.
- Surprise/Release (or Anterior Release) Test – This test indicates pain or apprehension when the shoulder is placed in a position of abduction, ninety-degree elbow flexion, and maximum external rotation.
- Rowe Test – A shoulder examination that indicates anterior instability; positive apprehension or increased motion can mean glenohumeral instability, while pain may mean rotator cuff ligament or tendon damage.
After a consultation, x-rays, and these various tests, your orthopaedic surgeon will make recommendations that could potentially run the gamut from everything from over-the-counter pain medication to surgery.
How anterior shoulder pain Is treated
The first goal of treating front shoulder pain is reducing the swelling and inflammation, alleviating the pain, and improving the range of motion and lifting capabilities of the affected shoulder joints.
Some of the methods for treating anterior shoulder pain are:
- Medication – Pain relievers or muscle relaxants may be prescribed; even over the counter drugs like ibuprofen, aspirin, or acetaminophen may be effective.
- Cold Therapy – Ice or similar cold treatments might be able to reduce the swelling and the pain from a shoulder injury or condition. Typically, it is recommended that the application of ice or cold treatments be done for at least ten or fifteen minutes every two to three hours.
- Surgery – This is of course the most drastic option, and performed in the case of a sustained or multiple instances of shoulder dislocation or similar issues that cause persistent pain and instability in your shoulder joint. An orthopaedic shoulder surgeon has the goal of helping you regain strength in your shoulder and allowing a more complete range of motion post-surgery.
Exercises that can help reduce anterior shoulder pain
There are three types of exercises that are commonly used to reduce pain in the front shoulder. These should be performed under the supervision of a trained medical professional such as a physical therapist upon the advice or prescription on an orthopaedic shoulder surgeon.
These exercises include:
Range of Motion Exercises – These movements help you achieve a full range of motion in your shoulder joints by ensuring your shoulders are moved in different directions. This helps your joints become more flexible and you’ll have more strength with a better sense of balance, helping to reduce your anterior shoulder pain.
The most common range of motion exercises for shoulder pain are pendulum and flexion exercises.
Stretching Exercises – Focusing on the flexibility and elasticity of the tendons in your shoulder joint, these exercises carefully and deliberately stretch and elongate the muscles and tendons, improving the range of motion and overall muscle control.
The standard stretching movements are seating and standing flexion along with external rotations.
Strengthening Exercises – Also referred to as strength training, these types of physiotherapy programs utilize resistance and weights to build up muscle strength and size in your shoulders, improving the stability of the joints.
Of course, these particular types of exercises should only be done under the advice of your physician or surgeon and well after recovery since they can cause muscle fatigue and soreness, which could cause existing pain to become increasingly worse.
Common exercises include scapular depressions and abductions, shoulder flexions, internal rotations, external rotations, scapular protractions, scapular retractions, and shoulder extensions.
All these exercises should only be done after recovery from the initial injury and any corresponding surgery or other treatments.
How to prevent anterior shoulder pain
While injuries and other shoulder conditions often cannot be helped, there are some things you can do to prevent or decrease the possibility of front shoulder pain, including things such as:
- Working on your overall strength, flexibility, and fitness
- Performing proper stretches and warm up work before any significant physical activity
- Allowing for plenty of recovery time between workouts
- Working with a professional and accredited physical trainer when you do work out
- Using proper gear and equipment during workouts and any sports you participate in.
Dealing with anterior shoulder pain
Front shoulder pain or anterior pain is one of the most common types of shoulder pain that people encounter, so you are hardly alone. There are various factors that can contribute to shoulder pain in general, but nearly all of them stem from various factors that cause injury and inflammation to the rotator cuff and tendons.
These conditions can greatly affect your normal functioning including your ability to lift even lightweight objects with the affected arm, or even raise that arm or rotate your shoulder due to the ongoing pain, swelling, discomfort, or stiffness.
Note that anterior shoulder pain can also be the result of preexisting chronic illness or other conditions.
While pain tablets can address your shoulder pain quickly, know that other measures like physiotherapy, cold compresses & ice therapy, and heat therapy should be considered as a long-term solution (always check with your orthopaedic doctor first).
More severe cases may require shoulder surgery in order to reduce pain and restore the normal range of motion in your shoulder joint.