In short — Shoulder pain is a very common reason for consultation. In about two out of three cases, it originates from the rotator cuff, the set of muscles and tendons that stabilize the joint. Most of these pains are benign and are treated without surgery The standard approach combines education, progressive exercises, and load management. Active physiotherapy is now the first-line treatment. At the On Therapy clinic in Grand-Saconnex, care aims to reduce pain, restore mobility, and sustainably strengthen the shoulder.
How does the shoulder work?
The shoulder is the most mobile the body—which also makes it the most exposed to pain. Its stability relies not on bones (the head of the humerus is only slightly socketed), but on a complex of muscles and tendons: the rotator cuff. These muscles keep the head of the humerus centered and allow the arm to be lifted and rotated.
This great freedom of movement explains why the shoulder is vulnerable to repetitive stress, overuse, and poor posture.
What are the causes of shoulder pain?
The most common cause, by far, is damage to the rotator cuff (tendinopathy, inflammation, sometimes partial tear). But other origins exist:
- Rotator cuff tendinopathy the most common, often linked to overuse or repetitive movements (arms overhead)
- Subacromial impingement (impingement syndrome): rubbing of the tendons when raising the arm
- Bursitis Bursitis
- Frozen shoulder (Frozen shoulder): progressive and significant stiffness of the joint
- Calcific tendinopathy calcium deposit in a tendon
- Arthritis of the shoulder
- Traumatic causes Acromioclavicular joint dislocation, sprain, fall
Note: images of tendon wear on ultrasound or MRI are not always responsible for the pain — they are found in many people without any symptoms. The physical examination remains central.
What are the symptoms?
Depending on the origin, shoulder pain can manifest as:
- one Pain on the side or front of the shoulder, sometimes radiating to the arm down to the elbow
- one Difficulty lifting arm, especially above the head
- one night pain, especially when lying on the affected shoulder
- one loss of strength or difficulty with everyday tasks (dressing, doing hair, reaching for an object above)
- one stiffness and a loss of range of motion (marked in case of capsulitis)
When should I consult?
It is useful to consult a professional without waiting too long An early-treated painful shoulder generally recovers better and avoids complications (stiffness, loss of strength, frozen shoulder).
Certain signs require a faster medical opinion:
- pain that occurred after a severe trauma (fall, shock)
- one marked loss of strength or an inability to raise the arm (suspected tear)
- one visible deformation of the shoulder (suspected dislocation)
- of the fever, a redness, significant swelling
- Severe pain that does not subside and strongly disrupts sleep
⚠️ If you see these signs, consult a doctor.
Do we need imaging?
Not systematically. For common shoulder pain, the The diagnosis is primarily clinical : the examination (mobility tests, strength tests, specific maneuvers) is most often enough to guide management.
Imaging (ultrasound, X-ray, MRI) is useful in certain cases: suspicion of a significant tear, pain resistant to treatment, traumatic context, or assessment before injection or surgery. As elsewhere, imaging performed too early can reveal minor abnormalities unrelated to the pain.
How to treat shoulder pain? The movement approach
The vast majority of shoulder pain, particularly rotator cuff tendinopathy, is treated without surgery. The modern approach, validated by recent studies, relies on a trio:
| Pillar | What it offers |
|---|---|
| Education | Understand the origin of the pain, alleviate fears, adjust daily and work movements |
| Progressive Exercises | Gradual strengthening of the rotator cuff and scapular stabilizing muscles, regaining mobility |
| Load Management | Dosage of activities: neither complete rest nor overload — gradually adapt the demands |
Complete rest should be avoided: it contributes to stiffness and weakness. Conversely, a well-balanced and progressive exercise program is now the most effective treatment. Manual therapy, combined with exercises, can help reduce pain and improve mobility.
5 Useful Exercises for Shoulder Pain
These exercises are provided for reference only and should be adapted to your situation. An exercise should not cause sharp pain: if in doubt, ask your physiotherapist for advice.
- Pendulum — lean forward, let the arm hang down, and make small, gentle circles to relax the shoulder without straining it.
- Scapular mobility — Whether standing or sitting, perform slow retraction (squeezing the shoulder blades together) and release movements to improve scapular rhythm.
- External rotation with a resistance band — Elbow at your side, gently rotate your forearm outward against light resistance to strengthen the rotator cuff.
- Wall slides — Facing the wall, slowly bring your hands up to regain range of motion.
- Progressive reinforcement — Adapted strengthening exercises, gradually increased according to tolerance.
Golden Rule: Aim for a comfortable and progressive workout. Sharp pain or pain that persists after exercise is a signal to adapt.
How long does shoulder pain last?
| Situation | Usual progression |
|---|---|
| Rotator cuff tendinopathy | Improvement on several weeks to a few months with active rehabilitation |
| Adhesive capsulitis («frozen shoulder») | Long, phased evolution, which can extend over Several months to 1-2 years |
| After a trauma | Variable depending on the lesion and management |
Regular exercise and early intervention are the factors that most accelerate recovery. Patience is part of the treatment: tendons strengthen gradually.
How to prevent shoulder pain?
- maintain the Mobility and strength of the shoulder and the scapula
- Avoid prolonged repetitive movements with arms above the head, or break them up.
- care for his/her/their posture (shoulders, back) at work and in front of screens
- increase gradually sustainable workloads in sports or at work
- act early on a developing discomfort rather than letting it settle in
Our approach at On Therapy in Grand-Saconnex
At the On Therapy practice, near Geneva, we treat shoulder pain with an approach active and progressive. Rather than rest, we prioritize resuming movement, strengthening the rotator cuff and scapular stabilizers, and adapting loads to your daily life and sport.
Each session begins with a precise assessment to identify the origin of the pain and to construct a plan tailored to your goals.
👉 Learn more about our sports physiotherapy in Grand-Saconnex.
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Frequently Asked Questions About Shoulder Pain
Should you rest a sore shoulder?
No complete rest. Maintaining appropriate movement and doing progressive exercises promotes healing; prolonged immobility maintains stiffness.
Does shoulder pain require surgery?
Rarely. The vast majority of shoulder pain, including many rotator cuff injuries, are treated without surgery through rehabilitation. Surgery is considered in specific cases.
What is frozen shoulder (adhesive capsulitis)?
It is a progressive and significant stiffness of the shoulder, which develops in several phases over several months. In the vast majority of cases, it responds well to conservative treatment with physiotherapy.
Do you need an ultrasound or an MRI for shoulder pain?
Not systematically. The diagnosis is primarily clinical. Imaging is reserved for certain situations (suspected tear, resistance to treatment, traumatic context).
How many physical therapy sessions for a shoulder?
It depends on the cause and how long it's been going on. Many cases improve with a few weeks of rehabilitation; others, like adhesive capsulitis, require longer follow-up. A plan is established after the assessment.
Is physical therapy reimbursed for shoulder pain?
Yes, with a doctor's prescription, covered by basic insurance (LAMal), according to your insurance conditions.
Article written by Patrick Berret, HES physiotherapist at the On Therapy practice (Le Grand-Saconnex, Geneva). Last updated: 06/07/2026. This article is for informational purposes only and does not replace a consultation. In case of pain, consult a healthcare professional.
Sources
- French National Authority for Health (HAS) — Diagnostic Approach for Non-Traumatic Adult Shoulder Pain and Management of Rotator Cuff Tendinopathies (2024)
- The Efficacy of Exercise Therapy for Rotator Cuff-Related Shoulder Pain (FITT Principle), J Orthop Sports Phys Ther, 2024
- ameli.fr (Health Insurance) — Shoulder Pain
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