Written by the SOS Clinic physiotherapy team.

Shoulder pain is common in people who lift weights, swim, play tennis, throw or play volleyball. It often starts as a niggle during a bench press, a serve or a long swim set. Many people push through it, then find it is still there weeks later.

The good news is that most gym and sport shoulder pain gets better without surgery. The main tools are smart changes to training and a well built strength program.

Why the shoulder gets sore

The shoulder has a huge range of movement. The ball of the upper arm sits on a small, shallow socket. Muscles do much of the work of keeping it steady, especially the rotator cuff and the muscles that control the shoulder blade.

Overhead sport and heavy lifting ask a lot of these muscles. When the load goes up faster than the shoulder can adapt, tissues get irritated and sore.

Common causes

Rotator cuff related pain. This is the most common cause. The rotator cuff tendons become sore and sensitive, often with pain on lifting the arm or reaching behind. You may hear it called rotator cuff tendinitis or shoulder impingement.
AC joint pain. The AC joint sits on top of the shoulder, where the collarbone meets the shoulder blade. It is often sore with bench press, dips, push-ups and reaching across the body.
Instability. Some shoulders are loose, or have been dislocated before. The shoulder may feel like it slips or gives way, often with the arm up and back, as in a throw or a serve. Read more about shoulder dislocation.
Labral and biceps problems. In throwing sports, the rim of cartilage around the socket can be strained, sometimes called a SLAP lesion.

Your physiotherapist will check which of these fits your symptoms. More than one can be present at the same time.

What raises the risk

Studies that followed overhead athletes over time have found a few factors linked with new shoulder pain. These include weaker shoulder rotation muscles, changes in how the shoulder blade moves, a past shoulder injury, and training load.^1,2 Some of these, such as a past injury, cannot change. Strength, shoulder blade control and training load can.

Managing your training load

Load means how much work you ask of the shoulder. It includes the weight, the number of sets and reps, how many throws or serves, how far you swim and how often you train.

Change it, but keep training. Total rest is rarely needed. Your physiotherapist can help you find a level of training that keeps pain mild and settled.
Swap the worst moves for a while. A different grip, a smaller range or a different exercise can often keep you lifting while the shoulder settles.
Watch for sudden jumps. A new program, a big competition week or returning after a break are common times for pain to start.
Build back up in steps. Increase one thing at a time and see how the shoulder responds over the next day.

Strengthening the rotator cuff and shoulder blade

Exercise is the main treatment for rotator cuff related pain. A large review found that rehabilitation programs with strength training or active exercise improved shoulder strength, while treatments without exercise did not.⁴

The research on pain relief is more mixed. A recent review found that, in the short term, exercise did not clearly beat hands-on and other passive treatments for pain, and the quality of the studies was low.⁵ Exercise still has the advantage of building the strength you need to get back to your sport. It also gives you something you can keep doing on your own.

Exercise can also help prevent problems. In a large trial in elite handball players, a short shoulder program done as part of the warm-up lowered the rate of shoulder problems over a season. The program worked on shoulder rotation strength, shoulder blade muscles and mobility.³

A typical program works on each of these areas.

strengthening for the muscles that turn the arm in and out
exercises for the muscles that control the shoulder blade
strength for the legs and trunk, which help power a throw or serve
mobility work where the shoulder or upper back is stiff
a gradual return to your full lifts or sport

Most programs need several weeks to show change. Your physiotherapist will adjust the plan as you get stronger.

Measuring shoulder strength

It is hard to judge shoulder strength by feel. At SOS Clinic, the physiotherapists use a VALD ForceFrame strength frame to measure the strength of the muscles that turn the shoulder in and out, and other shoulder movements. The test compares your sore side with your other side.

This helps show which muscles need the most work. Repeat tests show how you are progressing, and help guide when to increase training.

When surgery is discussed

Surgery is only considered for a small group, such as a large rotator cuff tear, a shoulder that keeps dislocating, or pain that does not improve after a good program. Read about shoulder arthroscopy and rotator cuff repair with Prof Phong Tran.

How SOS Clinic can help

The physiotherapists at SOS Clinic in East Melbourne see many people with gym and sport shoulder pain. Your first visit includes an assessment of your shoulder, your training and your goals, and a plan you can start straight away.

A biomechanical profile assessment can add a fuller picture, using VALD force plates, the ForceFrame strength frame and a 3D motion camera. If tight, sore muscles around the neck and shoulder are part of the problem, myotherapy can work alongside your program.

When to get help sooner

See a doctor promptly if your shoulder looks out of place or you think it has dislocated. The same applies if you suddenly cannot lift your arm after a fall or a heavy lift, or you have numbness, tingling or weakness down the arm. A hot, red, swollen shoulder with a fever also needs prompt care. Call 000 if shoulder or arm pain comes with chest pain, sweating or shortness of breath. During opening hours, contact the clinic. After hours and on weekends, go to your nearest emergency department.

Book a shoulder physiotherapy assessment at SOS Clinic

Frequently asked questions

Should I stop going to the gym with shoulder pain?

Usually not. Most people can keep training with some changes to the exercises, weights and range. Your physiotherapist can help you plan what to keep, change or pause.

Is it safe to keep bench pressing?

Often yes, with changes. A narrower grip, a smaller range or lighter weights may feel better. If it keeps flaring your pain, swap it for a while and build back up.

Why does my shoulder hurt more at night?

Night pain is common with rotator cuff related pain, especially when lying on the sore side. It often settles as the shoulder improves. Pain that wakes you every night and does not settle should be checked.

Do I need a scan?

Many people do not. A careful assessment often gives enough information to start treatment. Scans are useful if there was a significant injury, if a tear or dislocation is suspected, or if you are not improving.

How long until I can go back to full training?

It varies with the cause and how long the pain has been there. Many people return step by step over several weeks. Your physiotherapist checks your strength, movement and pain response to guide each step.

References

Hoppe MW, Brochhagen J, Tischer T, Beitzel K, Seil R, Grim C. Risk factors and prevention strategies for shoulder injuries in overhead sports: an updated systematic review. J Exp Orthop. 2022;9(1):78.
Salamh P, Bullock G, Chester R, Daniell H, Cook C, DeLang M, Tucker HR, Walker D, Lewis J. Risk factors associated with new onset of shoulder pain and injury among the athletic population: a systematic review of the literature. Int J Sports Phys Ther. 2025;20(3):315-32.
Andersson SH, Bahr R, Clarsen B, Myklebust G. Preventing overuse shoulder injuries among throwing athletes: a cluster-randomised controlled trial in 660 elite handball players. Br J Sports Med. 2017;51(14):1073-80.
Zhang B, Raguzzi IA, Dupuis F, Gianola S, Morgan-Daniel J, Roy JS, Pozzi F. Addressing shoulder weakness in individuals with rotator cuff-related shoulder pain: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2026;56(2):67-84.
Liu J, Tang D, Hu R, Dai Z, Liu Y, Ma R, Wan K, Rong X, Sun J, Wang L, Kong B. Effectiveness of exercise therapy versus passive conservative treatments for rotator cuff-related shoulder pain: a systematic review and meta-analysis of randomized controlled trials. Musculoskelet Sci Pract. 2026;83:103556.

Shoulder pain in the gym and overhead sport