The shoulder is the most complex and mobile joint in the body. Shoulder pain can be severe and very limiting; causing you a great deal of pain with activities like reaching up to a top shelf or into the back seat of your car, playing catch with your kids, or even combing your hair.
When we talk about the shoulder, most people think of the ball and socket joint of the shoulder. Technically that is correct. But pain free movement of your shoulder also requires movement of your shoulder blade, collar bone, ribs (especially the first rib which is high up in the muscle above your shoulder), and neck/upper back. Shoulder motion is the result of a complex series of movements of these individual bones that together give you the ability to reach up over your head. Problems with movement of any of these bones, which is often the case with shoulder pain, will cause you to have irritation and then inflammation of the 4 rotator cuff muscles. When this happens, you will experience shoulder pain with motion or, if severe enough, even when you are sitting still or lying on your side in bed.
The treatment of your shoulder pain starts with normalizing mobility of these structures with specific Manual Therapy techniques. As more normal motion returns, inflammation will decrease and your pain will get better. Strengthening of the 4 muscles of the rotator cuff is important to help keep the ball of your shoulder more securely in the socket so it doesn’t cause further inflammation. Strengthening the muscles that control your shoulder blade, which contributes to the socket of your shoulder joint, is also required as weakness here will also cause irritation of the shoulder. Finally, relearning movement patters for your shoulder will make sure your shoulder pain won’t return.