Written by the SOS Clinic physiotherapy team.

Shoulder arthritis can make everyday tasks hard. Reaching up to a cupboard, washing your hair or sleeping on that side may all hurt. The shoulder often feels stiff and may grind or click as it moves.

Exercise and physiotherapy are usually the first things to try. This article explains what they can offer, where the evidence is still thin, and how to make daily life easier while you work on your shoulder.

What is shoulder arthritis?

The main shoulder joint is a ball and socket. Both surfaces are covered with smooth cartilage. In osteoarthritis, this cartilage slowly thins and the bone underneath changes. The joint can become painful, stiff and weaker.

It is most common in people over 60. It can also follow an old injury, a dislocation or a large rotator cuff tear. The SOS Clinic page on shoulder arthritis explains the condition in more detail.

What the research says about exercise

There is much less research on exercise for shoulder arthritis than for hip and knee arthritis. The studies that exist are small, and good quality trials are still in progress.

A small Danish study tested a 12 week program of progressive shoulder exercises in 18 people who were on the path to shoulder replacement. The program was safe, most people kept it up, and on average their shoulder scores improved. The study had no comparison group, so it cannot show how much of the change came from the exercise itself.¹
A review of hospital records found that people with shoulder arthritis who were referred to physiotherapy had small short term gains in pain, movement and function. Only people with milder arthritis had gains in pain large enough to notice.²
A study that followed 62 people choosing their own non-surgical care found that about three in ten had a meaningful improvement over a year. In that study, people who had physiotherapy did no better on average than those who did not.³

A larger Nordic trial is now comparing shoulder replacement with a 12 week exercise program. Its results should give clearer answers.⁴

So exercise is a reasonable and safe first step, and some people improve a great deal. Others improve only a little, especially when the arthritis is advanced. A fair trial with a physiotherapist helps you find out which group you are in.

What a shoulder arthritis program looks like

Keeping the range you have. Gentle movement exercises, often done a few times a day, to stop the shoulder getting stiffer.
Strength around the joint. Exercises for the rotator cuff and the muscles around the shoulder blade, started light and built up slowly.
Posture and the upper back. A stiff upper back can limit how far the arm can lift. Mobility work here often helps.
Pain-guided progress. Mild discomfort during exercise is common. Pain that is clearly worse the next day means the program needs adjusting.
Practising real tasks. Reaching, lifting and carrying are trained in ways that match your daily life.

Making daily life easier

Bring things closer. Move often-used items to shelves between waist and shoulder height.
Keep loads close to your body. Carry shopping in two lighter bags, close to your sides, or use a trolley.
Pace jobs that hurt. Break up tasks like hanging washing, gardening or painting with rests and changes of position.
Support the arm at night. A pillow under or in front of the arm can make sleeping more comfortable.
Stay active. Walking, cycling and water exercise keep you fit and can help pain, even when the shoulder limits some activities.

When exercise is not enough

If pain and stiffness keep limiting your life despite a good trial of exercise, shoulder replacement is a well established option. Read about shoulder replacement with Prof Phong Tran. After any surgery, follow your surgeon’s advice on precautions and timelines.

How SOS Clinic can help

The physiotherapists at SOS Clinic in East Melbourne assess your shoulder, neck and upper back and talk with you about what you want to get back to. You leave your first visit with a plan and exercises you can start at home.

A biomechanical profile assessment can measure shoulder strength with the VALD ForceFrame. Repeat tests show whether your strength is changing over time.

Myotherapy can ease tight, sore muscles in the neck and upper back, which often work harder when the shoulder is stiff.

If exercise stops helping, the clinic team can arrange a review with Prof Phong Tran, an orthopaedic surgeon who works from the same clinic.

When to get help sooner

See a doctor promptly if your shoulder becomes hot, red and swollen, especially with a fever. The same applies if you cannot lift your arm after a fall, the shoulder looks out of shape, or you have new weakness or numbness in the arm. Shoulder or arm pain with chest pain or shortness of breath needs urgent care, so call 000. 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

Will exercise make my shoulder arthritis worse?

For most people, a well planned program is safe. In the small Danish study, no side effects from the exercises were seen. Your physiotherapist will adjust the program if pain flares.

Can exercise reverse arthritis?

No. Exercise does not regrow cartilage or change your X-ray. It aims to ease pain, keep movement and make the muscles around the joint stronger.

How long should I try physiotherapy?

Many programs run for around 12 weeks. Your physiotherapist will check your progress along the way so you can decide together what to do next.

Is it arthritis or a rotator cuff problem?

They can feel alike, and both can be present. A careful assessment and an X-ray help tell them apart, which guides the right exercises.

Can I still play golf or swim?

Often yes, with some changes. Your physiotherapist can help you adjust your technique or the amount you do so you can keep playing.

References

Larsen JB, Østergaard HK, Thillemann TM, Falstie-Jensen T, Reimer LCU, Noe S, Jensen SL, Mechlenburg I. Are progressive shoulder exercises feasible in patients with glenohumeral osteoarthritis or rotator cuff tear arthropathy? Pilot Feasibility Stud. 2022;8(1):168.
Baumann AN, Indermuhle T, Oleson CJ, Callaghan ME, Rogers H, Pennacchio C, Curtis DP, Leland JM. Comparing outcomes after referral to physical therapy for patients with glenohumeral osteoarthritis based on the radiographic osteoarthritis severity: a retrospective analysis. Cureus. 2023;15(8):e43027.
Su F, Sampson H, Anigwe C, Ma CB, Lansdown DA, Feeley BT. Effectiveness of nonoperative treatment in patients with glenohumeral osteoarthritis: a prospective cohort study. JSES Int. 2024;9(2):404-10.
Beck Larsen J, Thillemann TM, Launonen AP, Østergaard HK, Falstie-Jensen T, Reito A, Lund Jensen S, Mechlenburg I. Study protocol: Prosthesis versus Active (ProAct) exercise program in patients with glenohumeral osteoarthritis – a multicenter, randomized controlled trial. Acta Orthop. 2022;93:303-16.

Shoulder arthritis, what exercise and physiotherapy can do