The Reason Your Shoulder Pain Remains

Shoulder pain is a common issue with many athletes, even runners. Heck, it is simply a common issue with humans in general. It is something that tends to stick around forever, sometimes because you choose to ‘deal with it’ and sometimes because you are not getting to the root of the problem. 

Like many injuries, the self-care tendency with shoulder pain is to spot treat the area in which you feel discomfort. You stretch, smash, rub, etc. the area prior to training (and maybe after) so you can continue to train like you want. You continue doing that until…well…something worse happens and you are required to take a long time off for regenerative injections or surgery to heal the area. 

If you decide to go see a rehab specialist, they can get tunnel vision at times as well and only focus in on the area of pain, forgetting to address everything else that impacts the shoulder. The clinician does things to loosen up the tightness. You do a lot of rotator cuff strengthening and postural retraining. Over the span of a couple months, your pain resolves and you are sent on your way. And then months later the pain returns. You repeat the cycle over and over. 

This cycle often continues because the other things that impact how the shoulder functions were not addressed. When thinking shoulder, we also have to consider what is going on in the neck and the upper back, how you control the shoulder blade as you are moving your arm, and even what is going on in your hips and feet. Everything plays a roll!  

So, on to your shoulder issue and what else can be done about it… 

Neck 

A number of muscles in your neck area attach to the shoulder blade or collarbone. If any of them are tight, it can impact the mechanics of the shoulder complex. If you do not take time to loosen those up, the shoulder will never be able to move properly. 

Along with that, we cannot forget the possibility of referred pain. At times, shoulder pain is not actually shoulder pain. It is due to nerves in the neck area being pinched and referring pain to the shoulder or creating the tightness that is present in the shoulder. You can address the shoulder all you want, but if the issue is coming from the neck, it will never go away. 

Upper back 

The upper back tends to be a very stiff area in people. It is a stiffer portion of the spine in general, but we do need some ability to extend the upper back. Due to postures and habits of people, it tends to stay in a flexed/rounded posture. We cannot get good movement of the shoulder if we are unable to get any amount of spinal extension in the upper back. 

Play with this for a second: Slouch and raise your arm up over head. Take note of how high the arm goes up. Then, correct your posture into a more upright posture and do the same thing with your arm. How high does your arm go now? Huge difference, am I right? 

If you don’t address the upper back mobility when you are dealing with shoulder pain, you will never fully resolve your issues. 

Shoulder blade 

Our shoulder blade does a lot more than people think. Well, it is supposed to do a lot more. Due to learned habits and mechanics of your body, you often don’t have the control in the shoulder blade that you need to have for healthy shoulder mechanics. 

When you move your arm, with good mechanics the muscles surrounding the shoulder blade assist with the motion. What often happens instead is it is just the muscles around the shoulder joint that are doing the work. This places a lot of increased stress and strain on the deltoid, biceps, and rotator cuff in ways they were not meant to work. 

Unless you gain control of your shoulder blade with any and all of your arm movements, you will not resolve your shoulder issues. 

Hip and foot 

Because of how the body moves, it is often issues with the opposite side leg that create problems.  So, if your left shoulder is an issue, I would be curious what is going on with your right hip and foot primarily. (And that is not to say the issue cannot be on the same side hip and foot.) 

To put it simply, any weakness or mobility that is going on in the legs can create compensatory patterns and result in what seems to be an ‘overuse’ injury in your shoulder. 

Not sure where to go from here to resolve your shoulder pain? Start here:  

Upper back mobility 

Wall scapular retraction 

Prone shoulder extension 

Prone shoulder Ts 

Then email Dr. Brianne Showman at brianne@getyourfixpt.com to let me know how things go.