Quick answer: if your shoulder pain has not settled with rest or stretching, it is often because two things get missed: control of the joint before you load it with strength work, and the serratus anterior, a stabilising muscle around the shoulder blade that rarely gets a mention. Addressing both, alongside a proper assessment, gives shoulder pain the best chance of a full recovery.
Why rest and stretching alone do not always fix shoulder pain
Struggling to reach the top shelf without wincing? Finding it hard to sleep on that side, or to reach behind your back? If any of that sounds familiar, you have probably already tried the obvious things – resting it, stretching it, hoping it settles on its own. Sometimes that is enough. But when shoulder pain lingers, it is usually because two things get skipped.
At BOOST PHYSIO, these are the two we come back to again and again to help our patients with shoulder issues recover.
1. Build control before you build strength
Before loading a shoulder with strength exercises, our physiotherapists focus on improving control of the movement first. Aaran, Senior Physiotherapist at BOOST PHYSIO Hendon, demonstrates one of the drills we use for this: controlled circles against a ball held on the wall, keeping steady contact as you move.
It sounds simple, but it is a key way to retrain smooth, confident movement in a joint that feels unpredictable and painful.
2. Strengthen the serratus anterior – the shoulder muscle most people have never heard of
Meet the serratus anterior, a muscle that runs from the side of your ribcage to your shoulder blade (scapula). It controls how your shoulder blade moves.
It rarely gets a mention, but our physiotherapy team see how important this muscle is for a full recovery from shoulder injuries. When it is weak, the shoulder joint does not function as well as it should, which can leave pain and restriction in place even after other exercises have helped.
Aaran shows a simple serratus anterior strengthening exercise here:
When to see a physiotherapist for shoulder pain
These two exercises are a good starting point, but they work best as part of a wider plan built around your specific shoulder. If your pain is severe, getting worse or has lasted more than a couple of weeks, it is worth booking an assessment rather than guessing at exercises alone.
At BOOST PHYSIO, we offer:
- Same day physiotherapy appointments, 8am to 9pm
- Male and female clinicians
- Treatment recognised by BUPA, AXA and WPA
Book an appointment online now
Frequently asked questions about shoulder pain
What is the serratus anterior and why does it matter for shoulder pain?
The serratus anterior is a broad, fan-shaped muscle that runs from the upper ribs on the side of the chest to the inner edge of the shoulder blade. Its job is to keep the shoulder blade sitting flat against the ribcage and to rotate it upwards as the arm lifts overhead. When it is weak or not firing well, the shoulder blade can wing away from the ribcage or move out of sequence with the rest of the shoulder, a pattern physiotherapists call scapular dyskinesis. This throws off the mechanics of the whole joint and is a commonly overlooked contributor to pain that does not settle with rest alone. At BOOST PHYSIO, assessing scapular control is a standard part of every shoulder examination, not an afterthought.
How long does shoulder pain usually take to improve with physiotherapy?
This depends on the underlying cause, how long the pain has been present and how consistently the exercise programme is followed. As a general guide, many patients with non-traumatic shoulder pain notice a meaningful reduction in pain within a few weeks of starting a structured, physiotherapist-led programme, with fuller recovery of strength and range of movement typically taking two to three months. Shoulders that have been painful for many months, or where there is significant weakness, tend to take longer. A proper assessment gives a far more accurate personal timeline than general guidance like this.
What is the difference between control exercises and strength exercises for the shoulder?
Control exercises, like the wall ball circles in this article, retrain the nervous system’s ability to move the joint smoothly and confidently through a small, pain-free range. Strength exercises then build the capacity of the muscles to produce force through a fuller range, including overhead. Loading a shoulder with strength work before control has been re-established often reinforces the same faulty movement pattern that caused the pain in the first place, which is why BOOST PHYSIO physiotherapists usually sequence control before strength rather than starting with weights or resistance bands.
When should shoulder pain be assessed urgently rather than managed at home?
Most shoulder pain is safe to manage with gentle movement and, where needed, a physiotherapy assessment. Seek prompt medical attention if shoulder pain follows a significant fall or injury, if the arm cannot be lifted or rotated at all, if the shoulder appears visibly deformed, or if shoulder pain is accompanied by chest pain, breathlessness, sweating or pain spreading down the left arm, which can occasionally signal a cardiac cause rather than a musculoskeletal one. If in doubt, contact a GP, call 111 or attend A&E.
Does BOOST PHYSIO accept health insurance for shoulder physiotherapy?
Yes. BOOST PHYSIO is recognised by BUPA, AXA and WPA, and self funded patients are also welcome. Same day appointments are available from 8am to 9pm with both male and female clinicians across BOOST PHYSIO clinics in North London and Hertfordshire.
What happens in a shoulder physiotherapy assessment at BOOST PHYSIO?
The physiotherapist takes a detailed history of how and when the pain started, assesses range of movement and strength, and examines how the shoulder blade, neck and upper back are moving together, since problems in these areas often contribute to shoulder pain. Patients leave with a clear diagnosis where possible and a personalised exercise programme, rather than a generic sheet of exercises.
Book a shoulder assessment online now
Written with Aaran, Senior Physiotherapist at BOOST PHYSIO Hendon, and the BOOST PHYSIO team. This article is general guidance and is not a substitute for an individual physiotherapy assessment.
