The shoulder is assessed around the movement you need to regain.

An umbrella clinical term for pain associated with loading the rotator cuff and subacromial structures. It does not necessarily represent a single anatomical “impingement”; tendon, bursa, tissue capacity and load may contribute together.

• Lateral shoulder pain when raising the arm or working overhead
• A painful arc while lifting or lowering the arm
• Night pain or pain when lying on the affected side
• Pain-related weakness during elevation or rotation

A load-related condition affecting one or more rotator cuff tendons, most commonly the supraspinatus. It usually develops gradually and is not simply inflammation.

• Pain with lifting, throwing or resisted overhead exercise
• Pain with resisted external rotation or elevation
• Lateral or anterior shoulder tenderness
• Reduced tolerance for overhead work, gym activity or sport

A partial or full-thickness tear of a rotator cuff tendon caused by trauma or degeneration. Tears on imaging may also be present without symptoms, so their relevance depends on history, weakness and examination.

• Lateral shoulder and night pain
• Weakness when lifting or rotating the arm
• Sudden loss of function after a fall or heavy lift
• Difficulty raising the arm, combing hair or dressing

Irritation or inflammation of the bursa that helps the rotator cuff glide beneath the structures above it. It commonly coexists with cuff problems and cannot always be distinguished by symptoms alone.

• Pain over the lateral shoulder
• Pain with arm elevation or repeated overhead work
• Pain when lying on the affected shoulder
• Tenderness and pain-limited movement

A calcium deposit within a rotator cuff tendon, usually the supraspinatus. It may be asymptomatic, chronic or cause an intensely painful episode during the resorptive phase.

• Sudden severe pain or pain developing gradually
• Night pain and inability to lie on that side
• Marked restriction of arm elevation during an acute episode
• Pain and weakness provoked by overhead movement

A condition in which the glenohumeral capsule becomes painful and stiff, causing progressive loss of both active and passive movement. External rotation is typically particularly restricted.

• Pain that may be severe at night
• Progressive loss of active and passive movement
• Difficulty putting on a jacket, fastening clothing or reaching behind the back
• Restricted elevation and especially external rotation

Degenerative change affecting cartilage and surrounding structures in the main shoulder joint. Radiographic severity does not always match symptoms.

• Deep shoulder pain aggravated by activity
• Stiffness and progressive loss of movement
• Grinding or crepitus during movement
• Night pain and difficulty with daily activities

Degenerative change at the joint between the acromion and clavicle on top of the shoulder. It may be symptomatic or only an imaging finding.

• Pain localised to the top of the shoulder
• Pain when bringing the arm across the chest
• Tenderness over the acromioclavicular joint
• Pain with pushing, weightlifting or sleeping on that side

A sprain or tear of the acromioclavicular ligaments, usually after a direct fall onto the shoulder. Severity ranges from a mild sprain to visible displacement.

• Immediate pain on top of the shoulder after trauma
• Swelling, bruising or a visible prominence of the clavicle
• Pain when moving the arm across the chest
• Difficulty lifting the arm or carrying weight

Sprain, dislocation, osteoarthritis or inflammation at the joint between the clavicle and sternum. Posterior dislocation after trauma is rare but may threaten the airway and major vessels.

• Pain and swelling near the inner end of the clavicle
• Pain with shoulder movement or deep breathing
• Deformity or asymmetry after trauma
• Breathing or swallowing difficulty, or voice change after posterior dislocation — an emergency

The humeral head moves partly or completely out of the glenoid socket. It may be an acute traumatic episode or recurrent instability after injury to the capsule, ligaments or labrum.

• Severe pain and deformity during acute dislocation
• A feeling that the shoulder slips or is about to come out
• Apprehension in overhead or arm-behind positions
• Numbness over the outer shoulder or weakness after dislocation requires nerve assessment

A tear of the fibrocartilage rim around the glenoid; a SLAP tear affects the upper labrum near the biceps anchor. It can follow trauma, traction or repetitive overhead loading.

• Deep pain inside the shoulder
• Painful clicking, catching or locking
• Pain with throwing, overhead lifting or pulling
• Instability, weakness or a “dead arm” sensation in athletes

A load-related condition of the long-head biceps tendon at the front of the shoulder. It may coexist with rotator cuff or labral pathology.

• Anterior shoulder or bicipital-groove pain
• Pain with lifting, pulling or overhead work
• Tenderness over the tendon
• Clicking or catching when labral or stability problems coexist

A tear of the long-head biceps tendon near the shoulder, often through a weakened tendon and sometimes together with a rotator cuff tear.

• Sudden pain or a “pop” at the front of the shoulder
• Bruising extending down the upper arm
• A lower muscle bulge known as a “Popeye” deformity
• Weakness or pain with elbow flexion and turning the palm upward

A change in scapular position or control during movement; it is a functional presentation rather than necessarily a diagnosis in itself. It may accompany shoulder, neck or nerve conditions.

• Visible winging or asymmetric scapular movement
• Fatigue and discomfort around the shoulder blade during activity
• Difficulty or reduced performance in overhead work and sport
• Weakness, numbness or sudden onset requires nerve assessment

Irritation of a bursa or abnormal friction between the scapula and chest wall. It may relate to repetitive load, scapular control or, less commonly, bony changes.

• Pain along the inner border or beneath the shoulder blade
• Grinding, rubbing or snapping as the scapula moves
• Pain with repeated overhead activity
• Tenderness and fatigue in the muscles around the scapula

Fractures of the bones forming the shoulder girdle, usually after a fall, direct impact or high-energy trauma. They require medical assessment and imaging when indicated.

• Severe pain immediately after trauma
• Swelling, bruising, deformity or focal bony tenderness
• Inability to move or use the arm
• Numbness, a cold hand or weak pulse requires emergency assessment

Joint inflammation caused by rheumatological disease or infection. A hot, severely painful shoulder accompanied by fever may indicate septic arthritis, which is a medical emergency.

• Pain, warmth, swelling and marked restriction of movement
• Pain at rest and rapid deterioration
• Fever, chills or feeling generally unwell with infection
• Other affected joints or prolonged morning stiffness in inflammatory disease

Loss of blood supply to part of the humeral head, which may lead to bone and joint damage. It may relate to trauma, corticosteroids or other factors and requires medical assessment.

• Deep shoulder pain, initially with loading and later at rest
• Stiffness and progressive loss of movement
• Night pain in later stages
• Difficulty raising the arm and completing daily activities

Pain may be felt at the shoulder even when its source is the neck, a peripheral nerve, the heart, lungs or abdominal organs. The symptom pattern and associated signs determine the need for referral.

• Pain with numbness, tingling or weakness spreading from the neck into the arm
• Symptoms changing more with neck than shoulder movement
• Shoulder pain with chest pressure, sweating, nausea or breathing difficulty — an emergency
• Pain unrelated to movement, persistent pain or systemic symptoms require medical assessment