When we think of shoulder pain, most often it is associated with Rotator Cuff injuries and pathologies. The major functional feature of the rotator cuff muscles is their ligamentous role at the shoulder joint. As the strong flat tendons of these muscles cross the shoulder joint, they form a cuff that anchors the head of the humerus into the shoulder (glenoid) cavity of the scapula. These tendons act as the ligaments of the ligament-lacking shoulder joint. This unique design allows for incredible range of motion, but also leaves it prone to injury if the muscles aren’t properly able to maintain position with activities.
Rotator Cuff injuries are musculotendinous injuries or sprains. Either micro-tears to the fibers can occur, or a complete tear depending on the severity. Injuries to the tendons of the rotator cuff are usually a result of repetitive motions above the horizontal, (throwing a ball, swimming, lifting weights), falling on an outstretched arm, or carrying heavy objects with the arm hanging at the side. With a significant tear, client experiences weakness and cannot raise their hand over their head and often experiences pain while lying on the affected side. Tears can hurt all the time, even at rest, but especially on active range of motion. The shoulder will also be unstable.
Shoulder impingement can happen when the larger muscles that affect the position of the shoulder girdle (I.e.- Pectoralis, Serratus Anterior, Latissimus Dorsi etc.) pull the joint out of proper position and as the arm is raised above the head the top rotator cuff muscle (supraspinatus) that passes underneath the acromion process gets smashed. This of course creates a vicious cycle because the supraspinatus tendon can then get irritated and inflamed causing the space to continue to narrow. This also often also leads to Bursitis in the shoulder.
Frozen Shoulder Syndrome also called Adhesive Capsulitis, a condition where the capsule covering the bones, ligaments and muscle tendons of the shoulder becomes inflamed. The cause is not completely understood but most often is developed as a result of guarding as a client purposefully limits motion or as a result of immobilization after a severe injury. It is also believed that post injury or surgery scar tissue will develop which leads to pain, loss of range of motion, stiffness, and sometimes weakness.
No matter what starts what, shoulder pain can be a very complicated issue. There are 17 muscles that directly attach to our shoulder blade (scapula) and many more that affect its position. All must be balanced and working harmoniously to keep the shoulder pain free.
As Bodyworkers & Functional Movement Therapists we focus on balancing the muscle and fascial systems of the body to improve range of motion, posture, and support pain free living. We are able to view your muscle imbalances and Design the best treatment plan specific to your needs and properly address your shoulder pain.