Painful Arc in the Shoulder

A painful arc is a pain that occurs in your shoulder as you raise your arm out to the side. The pain usually happens when you raise your arm and it is parallel to the floor. The symptoms last until you move your arm fully overhead or lower it down. The painful arc in your shoulder can happen while you are raising your arm and lowering your arm. It is a signal that something is getting pinched in your shoulder while you are moving it.

Physical therapist taking notes with patient who has a pain in shoulder
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Physical Therapy For Shoulder Pain

If you have shoulder pain, you may be referred to a physical therapist or healthcare provider to help you determine the cause of your pain and to help you improve your shoulder mobility. Before receiving any treatment for your shoulder, your physical therapist or medical professional will likely perform an initial assessment. During this assessment, he or she will interview you to understand the nature of your shoulder problem, and then your physical therapist or practitioner will take various measurements.

Common impairments that your physical therapist or healthcare provider may measure include, but are not limited to:

  • Strength
  • Tenderness to palpation
  • Functional mobility
  • Range of motion (ROM)

While testing your ROM, your physical therapist or healthcare provider may use a goniometer to measure how far your shoulder joint moves in various directions. He or she will also be looking at the quality of the motion. If you experience pain during ROM testing while lifting your arms overhead, then a painful arc is present. This is a sign that shoulder impingement is occurring in your shoulder.

What Is Shoulder Impingement?

Your shoulder is a ball and socket joint. The ball is at the top end of your humerus bone in your arm, and the socket is part of your shoulder blade. There is a bony protuberance at the top of your shoulder blade called the acromion process.

If you have rotator cuff weakness or tightness in muscles or structures around your shoulder joint, the ball of the joint may move slightly upwards when you lift your arm. When this occurs, your rotator cuff tendons or your shoulder bursa may become pinched underneath the acromion process. This causes pain and the painful arc that happens while moving your arm. The pinching sensation is known as shoulder or rotator cuff impingement.

What Do I Do If I Have a Painful Arc?

If you have a painful arc during shoulder movements, your physical therapist or healthcare provider can help determine the cause of the problem. If tight muscles, tendons, or ligaments are the cause of the impaired motion in your shoulder, then stretching exercises may be prescribed. The towel rotator stretch may be attempted, or shoulder pulleys may be used to help improve your shoulder mobility.

If weakness in your rotator cuff muscles is causing your painful arc, then shoulder strengthening exercises may be prescribed. Shoulder active motion exercises, scapular stabilization exercises, or resistance band rotator cuff exercises may be necessary to help improve your shoulder strength. Working closely with a PT to ensure you are doing the right exercises can help you have a speedy recovery. Most episodes of shoulder pain from impingement last about four to six weeks.

Be sure to talk to your physical therapist or healthcare provider before attempting any shoulder exercises to ensure that you are exercising correctly.

Persistent Painful Arc

If your painful arc sign persists after working diligently on the shoulder range of motion and strengthening, there may be a rotator cuff tear in your shoulder. You should visit your healthcare provider to get an accurate diagnosis of your condition. Your practitioner may perform an X-ray, computed topography (CT) or magnetic resonance imaging (MRI) to check for signs of shoulder impingement, bursitis, or rotator cuff tear. If your shoulder pain and painful arc persist, you may need to return to your medical professional to seek out alternative treatments. These may include shoulder steroid injections or surgery.

A Word From Verywell

A painful arc can happen to anyone, and it may indicate a problem with your rotator cuff or shoulder joint. Your physical therapist or healthcare provider can determine why you are experiencing a pain arc and can make recommendations for the proper treatment for it. That way, you can quickly get back to your normal activity level with no shoulder pain.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hermans J, Luime JJ, Meuffels DE, Reijman M, Simel DL, Bierma-Zeinstra SM. Does this patient with shoulder pain have rotator cuff disease?: The Rational Clinical Examination systematic reviewJAMA. 2013;310(8):837-847. doi:10.1001/jama.2013.276187

  2. Correll S, Field J, Hutchinson H, Mickevicius G, Fitzsimmons A, Smoot B. Reliability and validity of the halo digital goniometer for shoulder range of motion in healthy subjects. Int J Sports Phys Ther. 2018;13(4):707-714. PMID: PMC6088125

  3. Garving C, Jakob S, Bauer I, Nadjar R, Brunner UH. Impingement syndrome of the shoulder. Dtsch Arztebl Int. 2017;114(45):765-776. PMID: 29202926.

  4. UpToDate. Radiologic evaluation of the painful shoulder in adults.

Additional Reading
  • Zaky LA. Effect of Exercise Program on Acromiohumeral Distance in Subacromial Impingement Syndrome. Journal of Medical Science And clinical Research. 2016. doi:10.18535/jmscr/v4i5.30.

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.