There are lots of reasons why you might have pain in or around your shoulder. Maybe you spent hours hunched over a computer, lifted something awkwardly above your head, or your dog suddenly took off after a squirrel and yanked the leash and your arm in the process. In some cases, the ache may arise on the top of your shoulder or in front of it, but it’s also possible for the pain to be concentrated around the shoulder blade.

The shoulder blade (scapula) is one of three bones that make up the shoulder joint. “Unless you fractured your shoulder blade, chances are it’s the muscles, tendons, or bursa in this region that are causing your shoulder blade pain,” says Julianne Payton, PT, DPT, a physical therapist at Hinge Health. Fortunately, there’s a lot you can do to relieve shoulder blade pain.

Read on to learn more about what causes shoulder blade pain and how to feel better with help from our Hinge Health physical therapists.

What Is Shoulder Blade Pain?

Your shoulder joint is made up of three bones: the upper arm bone (humerus), collarbone (clavicle), and shoulder blade (scapula). The scapula alone connects to 17 muscles, plus numerous tendons and ligaments and two nerves. These structures all work together to help you move the joint so you can do all sorts of things, like grab something off a high shelf, wash your hair, or return the ball in a game of tennis.

Shoulder blade pain refers to any pain around the scapula, says Dr. Payton. “It might be due to a strain to any of the muscles that sit under or over the shoulder blade or a rotator cuff injury,” she says. The rotator cuff is made up of muscles and tendons that originate from the shoulder blade and attach to the head of the upper arm bone, forming a "cuff" around it. Some people might have referred pain that originates in the neck or the top of the shoulder, but you feel it near the shoulder blade, she adds.

Causes of Shoulder Blade Pain

There are many reasons why you might feel pain around your shoulder blade, says Dr. Payton. They include:

• Prolonged sitting, including staying in the same position for too long. If you spend a lot of time with your arms in front of you — such as when you’re typing on a computer or scrolling through your phone — you can end up with stiffness around your shoulders or upper and mid back that may impact mobility, says Dr. Payton. Traveling for long periods while being scrunched in a car or airplane seat can cause the same issue.

• Injury. A sports injury that impacts your rotator cuff, or a fall in which you land on or bang your shoulder blade, could cause shoulder blade pain, says Dr. Payton. Some people strain one or more muscles around the shoulder blade by lifting something heavy without adequately preparing their body first or using the proper form.

• Shoulder impingement. This condition commonly occurs when the rotator cuff tendons get irritated and inflamed, which reduces the free space around the tendon. As a result, it can rub against the bone, causing discomfort. 

Common Treatment Options

Most causes of shoulder blade pain are the result of lack of movement or a muscle strain, and these injuries respond well to conservative treatment, says Dr. Payton. They include:

• Heat or ice. Heat can help relax tight, achy muscles, while ice tends to be better for acute injuries, but either is okay depending on your preference.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for shoulder blade pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Massage. Massage might help relax tight shoulder blade muscles that are contributing to your discomfort.

• Increased movement. Simply getting up and moving around frequently — which might mean taking breaks to stretch and walk around if you work a desk job — can help a lot, says Dr. Payton.

• Exercise that counteracts your usual position. “Biking, for instance, may not be the best exercise for shoulder blade pain if you sit at a desk all day because it also has you leaning forward,” she explains. “Pickleball, tennis, or swimming might be better because they introduce some rotation through your mid back.” 

• Physical therapy. A physical therapist (PT) can identify areas that are weak or stiff in your shoulders and upper back, and teach you specific exercises to target them. A PT can also help guide you through range-of-motion exercises, as well as stretching, strengthening, and stabilization moves (like the ones below) for your entire shoulder, upper arm, and upper back. You can see a physical therapist in person, or use a program like Hinge Health to access a PT via telehealth/video visit.