Shoulder pain when walking

The material in this article is from the work of Dr. Jolie Bookspan. Her superb book is entitled "Fix Your Own Pain Without Drugs or Surgery" (Healthy Learning Press, California).

The original article can be found at:

Neck Pain Article

What causes your shoulders to hurt when you walk?

A "forward head" is the source of much neck and shoulder pain.

The neck should be on a straight vertical line. Many people let their head and neck tilt forward. This is called a "Forward Head."

A forward head can eventually damage neck and upper back structures, as they bend and rub at angles they were not built for. Chronically holding neck muscles in an overstretched position weakens them. The forward head creates shortened, contracted muscles in front, and a stretched, weakened back. Cervical (neck) discs are pressured posteriorly.

But most standing, sitting, activity, and exercise is done with a forward head. Look in any fitness magazine. Most “abdominal muscle” exercises lift the body by the head – encouraged by "fitness" magazines, videos, gyms, and advertising. Look at how people eat. Look at how they carry backpacks and bags - hunching forward against the load instead of using muscles to hold their spine in healthy position. Then they do shoulder stands in yoga, which simultaneously overstretch the ligament, pressure discs outward, and create forces that generate bone spurs. The average person overstretches, and unequally stretches, their neck so much, that it is amazing they don’t hurt more.

The result is that the average person is too tight to stand up straight. Because of simple bad posture habits that tighten muscles on one side and overstretch them on the other, many people stand, walk, and do activities at joint angles that impinge, grind, rub, and stress. This creates a cycle of forward positioning that herniates discs and makes sore aching muscles, and the tightness and habits that keep you tilting forward. Much neck pain is ordinary mechanics and habits.

Poor standing and sitting ergonomics are a common cause of numb shoulder, upper back pain, and headache. It makes a classic "tension" pain across the shoulders, in a diamond pattern down the middle of the upper back, in the neck, up the neck to the head, and sometimes down the arm. Forward head is a common source of headache. Yet, after mechanically pressuring their neck all day, people call it stress and do not fix the very forward posture that would give them relief and stop the injury process.

The forward head is a surprising hidden source of shoulder pain and impingement. With the head held forward, it rotates the upper shoulder forward (round shouldered) which gets in the way of normal motion when you raise your arm. The upper arm bone squashes the soft structures of the shoulder capsule against the shoulder bone (where the scapula meets the clavicle). This can cause pain, squashing (impingement) and rotator cuff injury. How often does this happen? Every time you wash and comb your hair, pull off a shirt, put away groceries, stretch your head, brush your teeth, and reach for anything - in short, a forward head can cause shoulder and upper back and neck pain many dozens of times a day. The injury adds up over time.

Many people know they should keep their head lifted up and not drooping forward, but the front of their chest is so tight, that when they try to do it, either they arch their back, or crane their neck, or both. "Craning" the neck means "pinching" it back, with the chin and face lifted. Craning the neck is surprisingly common and a big source of neck and shoulder pain. Many people crane their neck to look up, to drink water, to reach overhead areas, even to eat. Check yourself to see if you jut your chin forward or hunch your shoulders up.

Stand near a wall, with your back to it, but not touching the wall.
Back up until something touches. Your buttocks? You may stand with your body flexed at the hip.
Did your upper back touch first? You may stand slouched backward.
Stand with your heels, hips, upper back, and the back of your head against a wall. Bring the back of your head against the wall without raising or dropping your chin, or arching your back.

If you can't keep your heels, hips, upper back, and the back of your head comfortably against the wall, or if you have to crane your neck, you are too tight to stand up straight. Pain results from the resulting bad positioning and slouching your tightness creates all day, every day. This is common. Here is what to do about it:

Check to see if you have tight pectoral (chest and front of shoulder) muscles which cause you to rotate your arms inward. To see if you do this, put your arms at your sides, look in the mirror and note direction of your thumbs. Do they face inward – toward each other? To restore this muscle group to functional resting length do these two stretches:

"Pec" Stretch (For pectoral muscles in front of your chest)

Face a wall and lift one arm up, elbow bent out to the side and behind you, as if "in a stickup."
Turn away from the wall, using the wall to gently brace your elbow back as you turn away.
Feel the stretch in the front of your chest.
Keep head and back posture in line. Don't let your back arch or your chin jut forward.
Hold just a few seconds, then switch arms.

- Drop your arms and look at your thumbs again. Thumbs should face forward now.
- Try the wall stand again. It should be easy to stand straight now.

Next, stretch the top of your shoulder (Trapezius stretch)

Tip one ear toward your shoulder. Don't round or hunch forward, or drop or raise your chin.
Breathe in, then while breathing out, slide your hand down the side of your body toward your knee. Feel a nice stretch along your entire side.
Hold a second or two then breathe in and out and switch sides.
Try the wall stand again and note that it is now easier to stand straight.
Try this against a wall to see if you keep the back of your head easily against the wall, rather than letting it slouch forward.

Do these two stretches many times a day to keep upper body posture healthy so your upper back and neck don't hurt, and so you can stand properly without the forward rounding that injures and brings on pain.

When you stop bending wrong and injuring your back dozens of times each day, it can begin healing with good exercises.

Neck pain exercises are misunderstood. People often injure their neck all day then hope to fix it with a few exercises. They don't understand when this does not work. They lie on the floor to do exercises, then stand up and walk away with no use of the positioning or strength they just practiced. It is like eating butter and sugar all day, then doing 10 minutes of exercises and wondering why it doesn't "work." The key is what you do all day.

Try this exercise slowly. See how you feel the next day, then increase. Use these exercises to retrain how to stand, sit and move all day.

Most people stretch their back by forward rounding but never strengthen the back and neck muscles that hold the back and neck upright. Upper back extension is an important exercise to strengthen at the same time that you practice moving your back in the other direction. Lie face down on the floor, hands and arms off the floor. Gently lift upper body without hands. Don't force. Don't crane your neck, keep it straight, just lift using upper body muscles.

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