What could be causing my shoulder pain? By Dr Niki McGuinness (Chiropractor)
The shoulder is probably one of the most complex joints in our body. I think what makes it the most difficult joint, is that it is not a stable joint such as the hip, which is a deep and tight, ball and socket joint. With the shoulder, the humeral head (the top part of the arm bone) has to be held tightly in a relatively shallow socket. In order for this to do so, the 4 rotator cuff tendons, along with ligaments, hold the arm bone in place. This is because the shoulder must have a larger range of motion. If you think about it, the shoulder can move up, down, in, out, over your chest, rotate in and out and do a 360 degree circle. It’s the ultimate mover joint!
In addition to the rotator cuffs performing optimally, there is also the shoulder’s side kick , the scapula. The shoulder relies heavily on the flowing movement of the scapula being able to tilt, move outwards, inwards and upward and without this flowing movement, the poor shoulder takes a real hit and works in overdrive.
‘So you can see, amidst all this, why it is easy for things to go wrong with the shoulder.’
So you can see, just in this small paragraph, which by no means even scratches the surface of the complexity of the glenohumeral and scapulohumeral relationship, why the shoulder poses many problems not only for the patient but also for the clinician.
In saying this, we do see the most common and then most unusual presentations of the shoulder. As Chiropractors, I feel we see more postural related impingement type shoulder problems, with the odd rotator cuff tear here and there.
On initial presentation of a shoulder complaint patient, I usually will assess not only the shoulder, but also the scapular and cervical spine motion. This allows us the rule out any primary shoulder capsule problems, such as labral tears but also to work out if any compensatory pain patterns are occurring.
‘It’s crucial the ‘nasties’ are ruled out with a quick assessment of the shoulder and the decision is made if this is a job for the surgeon or a physical therapist’
Treatment of the shoulder, especially when related to posture, begins with changing and educating the patient of the most optimal way to function without posing stress on the shoulder. My most important tool I use is the postural taping shown below. This is more of a proprioceptive approach, teaching the brain to ‘feel’ where the shoulder should ‘sit in space’. The taping also acts as a reliever on the rotator cuffs, as it pulls the humerus gently backwards, reducing the load on the tendons.
The patient shown below, was a crossfit competer with an old shoulder issue. This taping, was purely for performance enhancing of the shoulder to reduce the overactivity of the trapezius but also to provide more stability to the shoulder joint without impeding movement too much.
This is purely a proactive form of taping for such a gruelling sport, however this is an example of the taping I use in the initial stages of treatment for a shoulder complaint. Coupled with dry needling, a comprehensive rehab program and the use of the activator to treat compensatory neck pain, the patient usually responds favourably.
‘ In a nutshell, don’t ignore your shoulder pain’
So in a nutshell, if I could give you any advice, don’t ignore your shoulder pain. In the early stages, it really is reversible and treatment along with a good home exercise program, may prevent you ultimately from having to undergo shoulder repair surgery in the future.
If you would like to talk to us about your shoulder pain, call today and our chiropractors would be happy to discuss your case over the phone.