Your shoulder is the most mobile joint in your body. It comes into play in so many movements, from pushing open a door, to reaching overhead to get someone’s attention, to wrapping your arms behind you to zip up a dress, fix a collar, or scratch an itch. We rely on this level of mobility to get a lot of things done and usually don’t give it a second thought.

Because the shoulder joint is so mobile and incorporates so many different structures, it’s not uncommon for surrounding tissues to get overworked, leaving the shoulder irritated or inflamed. “While shoulder mobility is essential for daily movements, there’s always the risk of injury,” says Julianne Payton, PT, DPT, a physical therapist at Hinge Health. This can result in a shoulder sprain, in which one or more of the shoulder ligaments get overstretched; or a shoulder strain, in which shoulder muscles or tendons get injured. 

While the tissues involved in these injuries differ, the symptoms are usually the same, and so is the treatment. In both cases, Dr. Payton emphasizes that these kinds of shoulder injuries often resolve on their own with time and lifestyle tweaks, such as physical therapy and exercise.

Read on to learn more about what causes shoulder strains and sprains, along with how to prevent and treat them — especially with exercises recommended by our Hinge Health physical therapists. 

Shoulder Strain vs. Sprain

A shoulder strain or sprain might sound the same, but they’re technically different injuries. Shoulder strain happens when you pull a muscle or tendon, which can occur when you over-extend or over-stretch your shoulder. Sprains, on the other hand, result when you overstretch a ligament, or a tissue that attaches two bones together. 

Both strains and sprains can range from minor to serious. And while a tear in your muscles, ligaments, or tendons might sound alarming, they usually aren’t cause for major concern, and you can typically keep up with movement as you heal. Even though strains and sprains involve different tissues, Dr. Payton emphasizes the symptoms and treatments are generally the same in both cases. 

Shoulder Sprain and Strain Symptoms 

According to Dr. Payton, shoulder sprains and strains generally cause similar symptoms, including: 

• Achiness or soreness in your shoulder, especially with a more recent injury

• Stiffness in your shoulder, especially with an older injury

• Pain that radiates down your arm (typically not below the elbow)

• Shoulder weakness

• Difficulty lifting your arm overhead or behind your back 

Common Causes of Shoulder Strains and Sprains

Common causes of shoulder strains and sprains include: 

• Falling on an outstretched hand (tripping and trying to catch yourself)

• Twisting your arm while playing sports

• Falling directly on the side of your shoulder

• Performing repetitive movements, such as painting with your arm overhead

Shoulder Strain and Sprain Treatment Options

With strains and sprains, a bit of rest and avoiding activities that aggravate your shoulder immediately after injury can be helpful, but Dr. Payton stresses that incorporating movement as quickly as possible is key for healing and managing symptoms. “The shoulder is designed to move, so when you stop moving, it reduces the flow of healing nutrients the joint needs to stay healthy,” she says. 

The following tips from our Hinge Health physical therapists and medical doctors can provide relief for a shoulder strain or sprain.

Activity modification. While you may be familiar with the R.I.C.E. (rest, ice, compression, and elevation) approach to pain relief, there’s a more updated treatment strategy — P.E.A.C.E. and L.O.V.E. — that prioritizes gentle movement and activity modifications for shoulder sprains and strains. 

Over-the-counter (OTC) medication. Nonsteroidal anti-inflammatory medications (NSAIDs) such as naproxen (Aleve), ibuprofen (Advil, Motrin), and aspirin can all be helpful for pain from shoulder strains and sprains. It’s important to make sure that you’re safely able to take these medications, based on your medical history.

Ice and heat. Put ice or heat on your shoulder for 15-20 minutes up to four times per day. Ice is often more helpful in the first few days after a shoulder strain or sprain to reduce pain and swelling. After a few days, you can keep using ice or switch to heat. Test each out to see if one helps reduce symptoms like pain and stiffness more than the other.

Shoulder taping. Kinesio taping or sports taping can help relieve shoulder pain by offering some temporary extra support so you can continue to engage in day-to-day activities while you heal. A PT or healthcare provider can show you how to tape on your own.

Physical therapy. A March 2023 review in the British Journal of Sports Medicine found that a shoulder injury recovery program that included icing, stretching, and strengthening was very effective at reducing symptoms. A physical therapist (PT) can help guide you through range-of-motion exercises, as well as stretching, strengthening, and stabilization moves (like the ones below). You can see a physical therapist in person, or use a program like Hinge Health to access a PT via telehealth/video visit.