You’re clinging to the overhead strap on a packed bus during rush hour when the driver suddenly slams on the brakes. As the crowd surges, your arm jerks back and your shoulder takes the full force of the momentum. It’s times like these one is grateful for a strong and healthy shoulder.
“If you’ve got a strong and mobile shoulder, you have the control to reduce the risk of anything [bad] happening,” says Dr Josh Zadro, a physiotherapist and senior research fellow at the University of Sydney.
We often ignore our shoulders until they scream for attention, but prevention is far more effective than treatment, says Dr Anelise Silveira, a physiotherapist and researcher at the University of Queensland.
Here experts guide us through the principles of maintaining healthy shoulders:
Use your full range of motion daily
According to Zadro, problems arise when we stop moving entirely.
“There’s not one perfect posture,” he says. “People move and sit in a variety of ways … we’re not worried about that.”
He says “motion is lotion” – as we age and naturally lose mobility, shoulder health will decline. To remedy this, he recommends taking your shoulders through their full range of motion daily:
Arm circles: Large, controlled circles in front of your body.
The wall slide: Face a wall and slide your hands up as high as possible.
The overhead reach: Stretch your arms to the ceiling to counteract the forward hunch of computer work.
“Rather than trying to completely change the way people sit or work, it’s just a matter of getting out of those postures regularly,” Zadro says.
Silveira agrees, explaining that staying still for too long compresses tendons and the bursa – a small, fluid-filled sack that reduces friction between bones, tendons and muscles – leading to stiffness. Her advice for busy workers is to set a phone timer for every hour or two.
When it buzzes, perform a quick reset: check if you are slumping, then roll your shoulders back, around and down. Hold for five to 10 seconds and repeat up to 10 times.
“The goal is to become aware of your shoulders, strengthen the muscles and build a habit of adjusting.”
Strengthen shoulders safely
The shoulder relies on a team of muscles to function, including the rotator cuff – a group of muscles and tendons that supports and stabilises the arm at the shoulder joint – and the larger muscles across the front and back, Zadro says.
Prof George Murrell, a shoulder specialist, says that safe strengthening helps healthy shoulders.
He recommends low-impact options like swimming breaststroke, which he describes as “kind” to the joint, or using a rowing machine on a light setting to work the back of the shoulder and core without stressing the rotator cuff tendons.
Performing a simple routine with a resistance band a few times a week can strengthen the rotator cuff. Photograph: Tony Anderson/Getty Images
For a home setup, Zadro recommends grabbing a resistance band and performing a simple routine two to three times a week. The first exercise he suggests is the “stand and lift”, where you stand on the band and lift your arm to the side, then front, then overhead. He also recommends a move called “the door anchor”: for this, loop the band around a closed door handle. Face the door to pull (rowing motion), or face away to push (press motion), using the door as an anchor – hence the name.
Zadro says there is “no golden number of sets or reps”. Exercise until the muscle feels fatigued and the movement becomes difficult.
Silveira warns that even fit people who go to the gym and train a lot can have weak rotator cuffs and recommends isolating these muscles with rotations.
For an external rotation, keep your elbow at 90 degrees, tucked against your side and, while holding a resistance band or light weight, rotate the forearm outwards (away from your belly). Do the opposite for an internal rotation, moving the forearm inwards across your stomach. Once the movement feels easy, you can either add weight or increase your range of motion.
Increase new activities gradually
A fast way to wreck a healthy shoulder is a sudden spike in intense activity, Murrell says. Overworking the rotator cuff can lead to tendinopathy (tendon injury) and bursitis (inflammation).
He cautions against diving into high-intensity training programs like CrossFit without a strong exercise background, as high loads in a competitive environment can push the shoulder into a danger zone.
This applies to incidental exercise, too. Experts say we must be mindful of activities requiring repetitive overhead movement that the body isn’t conditioned for, such as painting a house or returning to tennis after a long break.
Silveira urges consistency over intensity. “You cannot go to the gym and expect to lift 50kg on your first day,” she says.
Zadro agrees: “A lot of shoulder problems happen when people suddenly take on a new or big load.”
Listen to pain
While these tips reflect best practice, the experts say if you experience pain, consult a health professional.
“Pain is our best friend,” Silveira says. “It tells you something is not quite right.”
Murrell suggests backing off aggravating movements immediately. He says that pain often causes people to stop using the shoulder joint proper (the ball and socket) and over-rely on the trapezius muscles to compensate.
A physiotherapist can spot these red flags, correct your movement patterns and guide you back into safe exercise once inflammation subsides.
