Shoulder and Neck Pain
That Keeps Coming Back
If you've tried stretches, massage, and endless YouTube exercises and the pain keeps returning, this page explains why, and what I do differently.
Not sure if this approach is right for you? Book a free 15-minute call to discuss.
Why Shoulder and Neck Pain Returns
Shoulder and neck pain is rarely caused by one thing. It's usually several factors that build up over time.
What contributes to shoulder and neck pain?
Your pain might be related to repetitive daily activities — how long you sit at your desk or how you hold your phone. Over time, these patterns add up.
It could be reduced strength or awareness in your upper back muscles. Or an imbalance in how the muscles around your neck and shoulders work together.
As we age or become more sedentary, we lose capacity and strength. The adaptability and resilience of our tissues also changes as we go through life. This affects how we use our bodies, and sometimes may result in less than optimal movement patters that become a habit over time.
Your shoulders and neck don't work in isolation. Issues elsewhere in your body — your mid-back, your ribs, how you breathe — can affect how your upper body moves and where you hold tension.
External factors matter too. Stress, lack of rest and recovery, work demands — these all influence how your body responds.
A Movement-Focused Approach
My approach focuses on understanding movement patterns, not just treating symptoms.
I assess movement quality in the context of your whole body mechanics and individual joints.
Understanding your movement patterns:
In your initial 60-minute assessment, I'll ask about your pain, when it started, what makes it worse, what you've tried. But I'm listening for patterns, not just symptoms.
Then I watch how you move. How your ribs expand when you breathe. Whether your shoulder blade glides smoothly when you lift your arm. How you hold tension through your neck and upper back.
I'm looking at how different areas of your body work together, and where suboptimal movement patterns place extra demand on other areas.
Finding the way forward:
Finding your way out of pain or discomfort that stops you doing the things you love, or simply need to accomplish in your day, is usually about spotting these patterns.
It might be patterns in how you train. Or staying inactive for days before launching into high-intensity or long-duration activity. Or doing a lot of an activity you love, like running, without preparing your body for success first.
My approach gets you thinking about these patterns. Then we collectively decide on an action plan.
What you might need:
That might be strengthening certain areas. Or improving range of motion to offload areas that are working too hard. Or developing better motor control. Or simply adding more movement variety to your routine.
The treatment:
The hands-on work addresses restrictions using soft tissue work, myofascial release, joint mobilisation. We also work through movements together in the session. This isn't just homework — you experience how your body can move differently, and we identify what you need to continue at home.
The goal is understanding what your body needs and building the capacity to move without pain returning.
Common Patterns I See
Desk and ergonomics-related neck and upper back tension
Your neck and shoulders stiffen after hours at the computer. The pain is worse by the end of the work day.
This requires a multifaceted approach. We explore:
Your breathing patterns (restricted breathing creates neck tension)
Core and trunk stability and control
How long you sit without breaks
Reduced capacity and strength in your upper back muscles
Chronic neck tension — with or without tension headaches
Constant tightness that massage only temporarily relieves. Sometimes radiates into your upper back or shoulder blade. Gets worse when you're stressed or tired.
We discuss stress and work intensity management options that you can implement yourself.
If you experience tension headaches, we also discuss whether you need to see a medical professional to rule out anything more serious that needs urgent attention.
Recurring shoulder pain
The pain comes and goes. It feels better after treatment, then returns weeks later. You notice it when reaching overhead or lying on that side.
We need to explore several factors:
Your postural and movement patterns during daily activities
Tendon health (tendons change with age and load)
Prior traumatic injuries, especially where rehabilitation wasn't performed or was unsuccessful..
Old injuries that never fully resolved
You injured your shoulder months or years ago. It "healed" but doesn't move the same. You've developed compensations that are now causing problems elsewhere.
We assess how the injury changed your movement patterns and what rehabilitation work might still be needed.
What Happens in Your Initial Assessment
Your first appointment lasts 60 minutes.
I'll assess how your whole body moves, not just your shoulder or neck. This is where I identify the restrictions and patterns causing your pain to return.
The session includes hands-on treatment using gentle techniques (soft tissue work, myofascial release, gentle mobilisation), and we'll work through movements together that address what your body specifically needs.
Between sessions, you continue these movements. They're tailored to what we found in your assessment, not generic exercises.
How many sessions?
For chronic shoulder and neck issues, typically 4-8 sessions. You'll leave your first session understanding why your pain keeps returning and with a clear plan forward.
Want more detail? Read the complete guide to your first appointment.
“Auste took her time speaking through the issue but also my lifestyle, occupation and daily habits so she could get a full view of the issue at hand.”
— Rebecca, Crystal PalaceBook Your Initial Assessment
If shoulder and neck pain keeps interfering with your work, exercise, or sleep, book an initial assessment and let's figure out what's actually causing it.
Not sure if this approach is right for you? Book a free 15-minute call.