Here’s a wild fact: At any point in time, one in four adults are dealing with shoulder pain. It’s common enough where you can’t just chalk up all that pain to acute or chronic shoulder injuries that might arise from playing sports or lifting weights. In fact, some of the most common causes of shoulder pain are just everyday bad (or less-than-ideal) habits.

Lara Heimann, DPT, a physical therapist and the creator of the LYT Method, says that the shoulders are particularly prone to muscle aches due to the complexity of the surrounding anatomy.  “The shoulder joint has a wide range of motion, allowing for various arm movements. This flexibility makes it susceptible to muscle imbalances, strains, and overuse injuries,” says Dr. Heimann. “Muscle imbalances, where certain muscles are stronger or weaker than others, can also be contributors to pain. Weakness in the muscles that support the shoulder blades, for example, may lead to instability of the shoulder joint and lead to discomfort in the surrounding area.”

Given the complexity of the area, there’s a lot of surprising ways that you can develop shoulder pain. But Dr. Heimann says that there are several very common habits that can make your shoulders ache—and some of them are pretty surprising. Keep reading to get the full list.

What are the most common causes of shoulder pain?

Okay, granted, there are some bad habits we do on the reg that pretty clearly will cause shoulder pain. Enemy number one: Bad posture. “Poor posture, such as slouching or hunching, is a big culprit that contributes to shoulder discomfort,” says Dr. Heimann. (Did you straighten up as you read that? Same.) That’s because rounded shoulders—which often happen when you’re slouching—place extra stress on the muscles, which can cause tension and pain, she says.

Generally, you should also be mindful about exercises or activities that overwork your shoulders. “Activities involving repetitive overhead movements, like lifting or reaching, may strain the shoulder muscles,” Dr. Heimann says.

As for the specific things that commonly cause (or exacerbate) shoulder pain, here’s Dr. Heimann’s list of top offenders.

1. Poor posture while sitting

Habit: Prolonged periods of slouching or hunching over a desk can strain the shoulders. (To which anyone with a desk job can attest!)

Solution: Dr. Heimann says that it’s important to sit tall with your head stacked evenly over your neck and your shoulders in a neutral position (not rolled forward). “Adjust your chair and desk height to maintain a neutral and upright spine,” advises Dr. Heimann. “Take breaks every 30 minutes to stand, stretch, and reset your posture.”

Looking for some exercises to improve your posture? Check out these PT-approved moves: 

2. Reaching overhead with bad form

Habit: Dr. Heimann says that reaching or lifting overhead with improper technique—whether that’s raising a medicine ball over your head in a workout class or just straining to grab the crackers on the top shelf of the grocery store—can stress the shoulder muscles and joints.

Solution: “When reaching for items, use a step stool or ladder to avoid overreaching. When lifting overhead, engage your core, keep the spine neutral, and lift with your hips and legs,” recommends Dr. Heimann. “Ensure your workspace is organized for easy access.”

3. Carrying heavy bags on one shoulder

Habit: If your go-to tote is less of a purse and more of a “ludicrously capacious bag,” as Tom Wambsgans from Succession would say…you probably have shoulder pain. That’s because heavy bags lead to muscle imbalances and may strain the overused shoulder.

Solution: Instead of carrying a heavy tote bag, purse, or laptop bag over one shoulder, Dr. Heimann suggests using a backpack or distributing the weight evenly in a shoulder bag. “Adjust the straps to keep the bag close to your body,” suggests Dr. Heimann. “If carrying heavy items, make multiple trips or use a wheeled bag.”

4. Spending way too much time on your phone

Habit: According to Dr. Heimann, holding your phone between your shoulder and ear during calls can strain your neck and shoulder muscles. Moreover, texting or constantly using your phone with both hands or one hand up in front of your chest while rounding your shoulders with a forward head will stress the neck and shoulders.

Solution: Dr. Heimann has several suggestions for how to prevent shoulder and neck pain from using your cell phone with poor posture. For starters, she recommends using a hands-free device (hello, headphones!) or a speakerphone when you take calls so you don’t have to hold the phone up to your ear. If you have to hold the phone, switch sides to distribute the load (and keep the duration of these calls to a minimum).

When texting, hold the device closer to eye level rather than dropping your whole head and bending your neck forward with a hunched posture.

5. Sleeping on your stomach

Habit: Dr. Heimann warns that sleeping on your stomach can lead to neck and shoulder misalignment. Why? You have to turn your face to the side, which causes pressure on the lower back and neck—and if you move around, the regular adjustments you’ll have to make will worsen the misalignment.

Solution: Dr. Heimann suggests the following solutions for this cause of shoulder pain: “Sleep on your back or side with a supportive pillow. Use a pillow that maintains the natural curve of your neck. If on your side, keep your spine straight, and if on your back, use a small pillow under your neck.”

Can strength training or stretching help with shoulder pain?

Dr. Heimann says that strength training and stretching can help alleviate shoulder pain caused by factors like poor ergonomics, muscle imbalances, or overuse. However, in order for any of these shoulder rehab exercises or stretches to be effective in the long term, it’s important to address both the root causes and incorporate targeted exercises.

“Strengthening the muscles around the shoulders, including the rotator cuff and upper back muscles, can improve stability and support,” says Dr. Heimann. “Stretching can improve flexibility, reduce muscle tension, and enhance overall shoulder range of motion.”

When strength training, “Focus on shoulder-specific exercises like shoulder presses and rows and include exercises that target the rotator cuff muscles for improved joint stability,” Dr. Heimann recommends. “Bodyweight exercises like planks and push-ups are an excellent way to build strength in the shoulders and core.” Be mindful of your form, and start with lighter weights to avoid overloading the shoulders, she adds.

Try this awesome shoulders and back strengthening workout for specific exercise recs: 

When stretching to address sore shoulders, Dr. Heimann says to target the chest, shoulders, and upper back with your routine. “Examples include doorway stretches, shoulder rotations, and neck stretches,” she recommends. “Hold stretches for 15-30 seconds, and perform them regularly, especially after long periods of sitting or repetitive activities.”

That said, while exercise helps, Dr. Heimann says it’s crucial to address poor ergonomics and posture. If you do not address the root cause, the problem cannot be resolved. “Adjust your workstation to maintain a neutral spine, keep shoulders aligned, and ensure proper desk and chair height,” she suggests. “Take regular breaks to stand, stretch, and reset your posture.”

Overall, Dr. Heimann says that the most effective approach to preventing and treating shoulder pain combines strength training, stretching, and ergonomic adjustments.

“This holistic strategy addresses both muscular imbalances and external factors contributing to shoulder pain. While exercise and stretching can be beneficial, they work best when integrated into a lifestyle that promotes overall musculoskeletal health,” she says. “Addressing the root causes of shoulder pain, including ergonomics and posture, enhances the effectiveness of these interventions.”

Lastly, Dr. Heimann adds that if your shoulder pain persists, you should consult with your healthcare provider or work with a physical therapist.

Need relief ASAP? Check out these easy, effective stretches for tight shoulders: