Could Your Clavicle Be Causing Your Shoulder or Hand Pain?

BLOG SECTIONS:

• What Does the Clavicle

• Clavicle Anatomy and Why It Matters

• How the Clavicle Moves With Your Arm

• What Happens When the Clavicle Is Not Moving Well

• How Hand Therapy Can Improve Clavicle Function

When people think about shoulder pain, they usually focus on the rotator cuff or the shoulder joint itself. One bone that is often overlooked—but critically important—is the clavicle, also known as the collarbone. The clavicle plays a central role in how your arm moves, how forces transfer through your shoulder, and even how nerves and blood vessels travel from your neck into your arm. When it is not moving well, pain and dysfunction can show up anywhere from the neck down to the hand.

As occupational therapists and hand therapists, we pay close attention to the clavicle because it directly influences shoulder mechanics, nerve mobility, and upper extremity function.

A Simple Overview of Clavicle Anatomy

The clavicle is an S-shaped bone that sits horizontally between the breastbone (sternum) and the shoulder blade (scapula). It acts as a strut, holding the shoulder out away from the body so the arm can move freely.

It connects to the body at two joints. On the inner side, it meets the sternum at the sternoclavicular joint. On the outer side, it connects to the shoulder blade at the acromioclavicular joint. These two joints allow the clavicle to rotate, elevate, and glide as the arm moves.

Several important muscles attach to the clavicle. The pectoralis major helps with pushing and bringing the arm across the body. The deltoid assists with lifting the arm. The trapezius helps stabilize and rotate the shoulder blade, and the sternocleidomastoid influences neck and head position. Because of these attachments, tightness or weakness in one area can affect how the clavicle moves.

Just beneath the clavicle is a busy highway of structures, including the brachial plexus (the nerves that supply the arm and hand) and major blood vessels. If the clavicle sits too low, too forward, or does not move properly, these structures can become irritated or compressed.

How the Clavicle Should Move With Arm Motion

Although the clavicle looks like a simple bone, it moves in very specific ways when you raise your arm. As your arm lifts overhead, the clavicle should elevate, rotate backward, and glide smoothly at both joints. This motion helps create space under the shoulder so tendons and nerves are not pinched.

If the clavicle does not rotate or glide properly, the shoulder blade cannot move well either. Over time, this can decrease space in the shoulder and contribute to impingement, stiffness, or nerve symptoms. Many people unknowingly compensate by using their neck or upper traps more, which can create additional discomfort.

Healthy clavicle movement is quiet and efficient. You should not feel pinching, catching, or tension in the front of the shoulder or base of the neck when lifting your arm.

Common Problems Linked to Poor Clavicle Function

When the clavicle is not doing its job, a variety of diagnoses can develop. Shoulder impingement is one of the most common, often presenting as pain when reaching overhead or behind the back. AC joint irritation can cause localized pain on the top of the shoulder, especially with cross-body movements or sleeping on that side.

Some people develop thoracic outlet–type symptoms, where nerves or blood vessels are compressed under the clavicle. This can feel like numbness, tingling, heaviness, or fatigue in the arm or hand. Neck tension, headaches, and postural pain are also frequently connected to poor clavicle positioning.

Signs to watch for include shoulder pain that does not improve with basic exercises, clicking or discomfort at the front or top of the shoulder, symptoms that travel into the arm or hand, or difficulty lifting the arm smoothly overhead.

How Hand Therapy Can Help

In hand therapy, we look beyond just the hand or wrist. If the clavicle is not moving well, the entire upper extremity can be affected. Treatment often starts with skilled manual therapy to address stiffness at the sternoclavicular and acromioclavicular joints and to release tight soft tissue that may be restricting movement.

Joint mobilizations and mobilizations with movement are used to help restore normal glide and rotation of the clavicle while the arm is moving. This approach helps retrain the body to use the clavicle correctly during functional tasks rather than isolating movement in one area.

Exercise is also a key component. We focus on improving posture, activating the muscles that support proper shoulder and clavicle mechanics, and restoring coordinated movement between the shoulder blade, clavicle, and arm. The goal is not just to reduce pain, but to improve how the entire system works together during daily activities.

The Takeaway

The clavicle may be small, but its impact is significant. When it moves well, the shoulder, arm, and hand can function smoothly and efficiently. When it does not, pain and dysfunction often follow. Addressing clavicle mobility and mechanics is an important part of comprehensive upper extremity care, especially in hand therapy.

If you are experiencing persistent shoulder, arm, or hand symptoms that do not seem to improve, it may be worth taking a closer look at how your clavicle is moving. Sometimes the missing piece is not where the pain is felt, but one joint up the chain.

At Baytide Health, we take a whole-arm approach to care. If shoulder, arm, or hand pain is limiting your daily activities, individualized hand therapy in your home may be the next step.

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