Anterior Shoulder Pain Prescriptions

Anterior shoulder pain commonly presents as a pinching or aching sensation at the front of the shoulder, often worsened by pressing movements, reaching overhead, or sleeping on the affected side. This protocol addresses the most common contributors: tight pecs, restricted internal rotation, and weak rotator cuff stabilizers.

Protocol

Step 1: Soft Tissue Work

Release the anterior structures that pull the shoulder forward and create impingement.

• Pec minor release: Lie face-down with a lacrosse ball under the chest, just below the collarbone and inside the front of the shoulder. Breathe and hold for 60–90 seconds per side.
• Anterior deltoid release: Pin a lacrosse ball between the wall and the front of your shoulder. Make small arm circles while pinned. 60 seconds per side.
• Biceps tendon release: Using your opposite thumb, apply gentle pressure along the biceps tendon (front of the shoulder in the groove). Hold tender spots for 20 seconds.

Step 2: Mobilization

Restore range of motion in the structures that are limiting healthy shoulder mechanics.

• Doorway pec stretch: Stand in a doorway with your arm at 90 degrees. Step forward until you feel a stretch across the chest. Hold 30–45 seconds per side.
• Sleeper stretch: Lie on the affected side with the arm at 90 degrees. Use the opposite hand to gently push the forearm toward the floor (internal rotation). Hold 30 seconds.
• Cross-body stretch: Pull your arm across your chest with the opposite hand. Hold 30 seconds per side.
• Wall slides: Stand with your back against a wall. Slide arms from a “cactus” to overhead position, keeping full wall contact. 10–12 reps.

Step 3: Movement Reset

Rebuild stability and proper movement patterns.

• Banded external rotation: With a band anchored at elbow height, rotate the forearm outward with the elbow pinned at your side. 12–15 reps per side.
• Face pulls: Using a band at face height, pull toward your face with elbows high, finishing with external rotation. 12–15 reps.
• Prone Y-raises: Lie face-down, raise arms in a Y position with thumbs up. 10–12 reps, focusing on lower trap activation.

When to Use

• Before upper body training sessions
• When experiencing front-of-shoulder aching or pinching
• As a daily protocol if you have a history of shoulder impingement
• After sleeping on the affected shoulder

When to Seek Professional Help

• Pain does not improve after 3–4 weeks of consistent use
• Shoulder catches, clicks, or locks during movement
• Weakness when lifting the arm or holding objects
• Pain at night that disrupts sleep consistently
• History of shoulder dislocations or labral tears
• Sudden onset of sharp pain without a clear cause