Diagnose Shoulder Problems By Location: The Complete Assessment Guide

Waking up with a stiff joint is one thing; realizing you can’t lift your arm to wash your hair is entirely different. When you are trying to diagnose shoulder problem triggers, confusion is the first hurdle. Is it a tear? Is it just inflammation? Or is it referred pain from your neck?

The shoulder is the most mobile joint in the body, which also makes it the most unstable. Understanding the root cause isn't just about stopping the pain; it's about preventing permanent mobility loss. This guide breaks down the assessment process based on location, movement, and mechanical feedback.

Key Takeaways: Quick Assessment

• Front of Shoulder: Often indicates Biceps Tendonitis or Rotator Cuff Impingement.
• Top of Shoulder (The Bump): Usually points to AC Joint separation or arthritis.
• Deep/Internal Ache: Frequently associated with Labral tears or Frozen Shoulder.
• Painful Arc (60-120 degrees): Classic sign of Subacromial Impingement.
• Weakness vs. Pain: Weakness usually signals a tear; pain usually signals inflammation.

Shoulder Pain Location Diagnosis: Where Does It Hurt?

The first step in the diagnosis of shoulder pain is pinpointing the epicenter of the discomfort. Because the shoulder girdle is complex, "it hurts everywhere" is a common complaint, but specific spots reveal specific injuries.

1. The Anterior (Front) Pain

If the pain is focused on the front of the deltoid, specifically in the groove of the muscle, you are likely dealing with Biceps Tendonitis or anterior impingement. This is common in athletes who do heavy pressing movements. If you press on the tendon groove and feel a sharp zing, that is a positive sign of tendon inflammation.

2. The Superior (Top) Pain

Touch the bony bump on top of your shoulder. If this specific spot is tender, or if there is a visible step-off (one bone sitting higher than the other), the diagnosis for right shoulder pain (or left) in this area is often AC Joint dysfunction. This is common after a fall or heavy dips.

3. The Lateral (Side) Pain

Pain radiating down the side of the arm (but stopping before the elbow) is the hallmark of rotator cuff pathology, specifically the Supraspinatus tendon. This is often referred pain from the tendon getting pinched under the bone.

Diagnosing Shoulder Pain by Movement

Static pain tells us one thing, but identifying shoulder pain through movement patterns provides the mechanical context. Doctors use specific provocation tests to isolate structures.

The Painful Arc Test

Lift your arm out to the side (abduction). If you feel little to no pain at the start, but sharp pain kicks in between 60 and 120 degrees, and then disappears as you get fully overhead, this is a classic impingement sign. The bones are pinching the bursa or tendon only during that specific range of motion.

The Reach Test

How to diagnose shoulder pain involving the capsule or frozen shoulder? Try to reach up your back as if scratching between your shoulder blades. If you have a massive discrepancy between your good arm and bad arm (e.g., the bad arm gets stuck at the waist), you may be looking at Adhesive Capsulitis (Frozen Shoulder) or significant internal rotation deficits.

Common Shoulder Pain Injury Diagnosis Profiles

By combining location and movement, we can form a clearer picture of the injury.

Rotator Cuff Tears

The key differentiator here is weakness. If you diagnose my shoulder pain as just "hurting," it might be tendonitis. But if you cannot lift your arm despite trying hard (the brain says move, the arm says no), you are likely dealing with a structural tear. Night pain that prevents sleeping on that side is also a major red flag.

Labral Tears (SLAP Lesions)

This is often a deep, clunking sensation. You might feel the shoulder "catch" or lock up during overhead movements. This is mechanical interference inside the joint socket, common in overhead throwers or CrossFit athletes.

My Training Log: Real Talk

I spent six months ignoring what I thought was just "bench press shoulder." I convinced myself it was just tight pecs. But the reality check didn't happen in the gym; it happened in my driveway.

I reached into the back seat of my car to grab a gym bag—an awkward, external rotation movement while extending backward. The flash of pain was so sharp my vision actually blurred for a second. It wasn't a dull muscle ache; it felt like a hot wire inside the front of my delt.

When I finally tested it, I realized I had zero stability at the top of a press. The bar wasn't just heavy; it was wobbling because my subscapularis had checked out. That specific "seatbelt reach" pain is now my immediate indicator to back off pushing volume and focus on internal rotation rehab.

Conclusion

Learning how diagnose shoulder pain effectively is about listening to the subtle cues before they become screaming injuries. Whether it is a location-based ache or a movement-based pinch, early identification allows you to modify your training and seek professional help before surgery becomes the only option. Respect the joint, and it will keep you moving.

Frequently Asked Questions

How do I know if my shoulder pain is serious?

If you experience numbness running down the arm, sudden weakness where you cannot lift the arm, or if the shoulder looks physically deformed, seek immediate professional care. These are signs of nerve involvement or acute structural failure.

Can I self-diagnose shoulder impingement?

While you can't get a definitive medical diagnosis without imaging, diagnosing shoulder pain by movement like the Hawkins-Kennedy test (raising arm to 90 degrees and rotating inward) can give you a strong indication. If that motion reproduces your specific pain, impingement is likely.

Why does my shoulder hurt only at night?

Night pain is a specific characteristic of rotator cuff tendonitis or tears. When you lie flat, gravity no longer pulls the humerus down, allowing it to migrate up and compress the inflamed tendon, causing a throbbing ache that disrupts sleep.