Shoulder pain can come in many degrees from debilitating to annoying. It can have a phantom like presence, there one moment, gone the next. It can give you headaches or disrupt your breathing. Stretching can sometimes remedy the pain. Rolling on trigger points of the shoulder blade (scapula) with a tennis ball or a racket ball can be effective. If you’re searching for relief you’ve probably tired some of these things without success. It’s my job to help you understand shoulder pain from an unconventional point of view. I’ve had great success alleviating it, here are 7 reasons why.
- When pain comes we get myopic. Above is a good picture of some of the rotator cuff muscles. You can see that they converge into a single tendon that wraps the head of the humerous. The cause of shoulder pain can be elusive, often our first reaction is to dig into the shoulder at one of the muscles. You’ve probably done it, the rubbing feels good, but surprisingly, relief is as temporary as the rub. Why?
- The shoulder joint is the most unstable joint in the body. Its ingenious design is for dynamic movement. Because we’re able we put our shoulder’s through all sorts of stuff. If you’re an athlete its range of motion might be challenged. If you’re a student tension from stress can build up in the shoulders. So it’s unstable and is affected three dimensionally.
- Our arms are anatomically behind us. If you look at the picture above, the shoulder blade rests on the back of the rib cage. The problem is that we focus so much on the world in front of us that we use our arms as though they’re located in front of us and they’re not, so we spend our lives pulling them forward and out of place, then when we sneeze or pick up a kleenex and throw out our shoulders we’re baffled.
- Three dimensional forces. Now, if we turn the picture around here’s the shoulder blade from the front. So, in our minds we’re building up the three dimensional image of the shoulder, super important in understanding this complex area. I talked about the shoulder blade’s home being on the back of the rib cage, here we see four friends calling that shoulder blade out to play. The coracobrachialis and the pectoralis minor drag that scapula forward.
- The foundation. We think of the shoulders as unstable, but the other way to look at them is that they are made to have a wide range of motion and be responsive. The structural foundation of the shoulder is the rib cage. The ribs don’t lend much support to this overused tool, but really they aren’t supposed to, however when there are imbalances in the shoulder blade it will hunker down to anchor for stability. Wrong move. The shoulder is supposed to float on the ribs like a ship on water. It’s supposed to be responsive not stuck and fixed.
- Distant relationships. Connecting at the highest point of the shoulder blade its position can be easily influenced by the clavicle. The sternum and first ribs are distant anchoring points for the clavicle and if they feel a tug of war from the other areas we can see how the rotator cuff muscles would be overstretched and their optimal tension being compromised. If the clavicle is frozen medially, you’ll be sure to hear protests from the shoulder blade.
- The central connection. Let’s return to the back and look at one more area of influence.The medial border of the shoulder blade is taken up by the Levator and the Rhomboids. The Levator can become tense pulling the shoulder blade up. Doing that opens up the door for the scapula to go up and over the ribcage and that affects the Rhomboids. They become compromised because they’re actually weak muscles. The Rhomboids are better at stabilizing the scapula, pulling it back is too laborious and so they weaken and give up.
When you have shoulder pain and there isn’t a clear causation, you’ve been to everyone and tried everything consider the dimensions outlined here. The shoulder dynamic is three dimensional but it’s elusive because pain doesn’t always feel that way. If you want the best shoulder fix it’s 3-D reality must be balanced.