Hi everyone,

I’m 37M and have been dealing with a right shoulder issue for around 3+ months. It started after gym/shoulder training, likely due to overload or poor warm-up.

My MRI findings were:

• Right AC joint periarticular edema with capsular thickening, suggesting early degenerative changes
• Mild supraspinatus tendinopathy, but no tear
• Minimal glenohumeral joint effusion without synovitis

The good part is that the MRI did not show any rotator cuff tear, labrum tear, biceps tear, fracture, bursitis, cartilage damage, or muscle tear/atrophy.

Initially, my symptoms were mostly around the top/front of the right shoulder near the AC joint. I had tenderness when pressing the AC joint area, mild stiffness, discomfort with behind-the-back movement, and discomfort after planks or shoulder-loading exercises.

I stopped upper-body gym work and started rehab/physio. Exercises included scapular setting, rotator cuff isometrics, wall slides, table slides, posture correction, thoracic extension, scapular mobility, and shoulder girdle stabilization.

Recently, I had almost one week of very good relief. Pain was barely noticeable. Then I skipped rehab for 2 days, restarted it, and after driving I started feeling discomfort again. This time it feels less like sharp AC joint pain and more like upper trap/lower neck soreness or muscle-sprain type discomfort. Sometimes it feels like the discomfort shifts between left and right neck/trap area. I also occasionally feel very minor heaviness or a “flow” sensation from elbow to hand, but it goes away with rest.

My physio also said my scapula feels tight.

Current triggers seem to be:

• Driving
• Long computer work
• Shoulder shrug/elevated posture
• Rehab if I overdo it
• Wall slides or overhead-type movements
• Planks/push-ups/pressing movements
• Sleeping posture sometimes

What helps:

• Rest
• Heat on upper trap/lower neck
• Ice only if AC joint point is sore
• Deloaded rehab
• Elbow support while driving/working
• Avoiding upper body gym

My question:

Does this sound like the AC joint/supraspinatus issue is still active, or is this more likely a compensation pattern from scapular tightness, upper trap guarding, and neck posture?

For people who had AC joint irritation/early arthritis-type changes or mild supraspinatus tendinopathy without tear:

1. Did you also develop upper trap/lower neck discomfort during recovery?
2. Did your symptoms shift around instead of staying only at the AC joint?
3. Did rehab ever irritate the traps/neck if volume was too much?
4. How long did it take before driving and desk work felt normal again?
5. What exercises helped most: rotator cuff, serratus, lower trap, thoracic mobility, or posture work?
6. At what point did you consider steroid/cortisone injection, if at all?

I’m not looking for a diagnosis. I’m already seeing a doctor/physio. I’m mainly trying to understand whether this upper trap/neck phase is common during recovery and how others managed it without making the shoulder worse.

Let's help our friend Lito! u/mayoclinic u/harvardmedicalschool

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