What is actually the root cause of your shoulder pain?

By: Rachel Herrmann, DPT
The shoulder is a common region in which people complain of pain. It can often be a confusing region to have pain, too. Some people describe their shoulder pain along the top of their shoulder to their neck. Some people have shoulder pain about their shoulder blade. Others describe their shoulder pain along the front of their shoulder or the top of their shoulder or the back of the shoulder or radiating down the shoulder to arm, elbow and even all the way to the hand at times. There are many different reasons for shoulder pain and therefore many different presentations of shoulder pain.  This is because the shoulder is a lot more complicated than it looks from the outside.
Many people have learned the shoulder to be a ball and socket joint, which is true, but this does not fully paint the picture of the shoulder. The shoulder is actually a complex made up of 3 different joints. There is the glenohumeral joint which is the well-known ball and socket joint of the shoulder connecting the arm bone to the shoulder blade. Then there Is the acromioclavicular joint which attaches the shoulder blade to collar bone. This is the bony attachment essentially connecting the whole upper extremity to the trunk of the body. And third, there is the scapulothoracic joint in which the shoulder blade moves along the thoracic portion of the back of the rib cage.
In addition to the shoulder having multiple moving joints, it has even more muscles in order to help control the various movements that need to occur at each joint in order for you to be able to reach up and grab a plate from the cabinet, to coordinate you swinging the tennis racquet, or to help you manipulate your arm to scratch that itch in the middle of your back.  Some of the muscles that attach to your shoulder blade and collar bone also attach to your neck, midback, chest, and ribs. So due to their interconnectedness and close proximity it is not uncommon for neck or upper back and shoulder issues to sometimes be related or for one to follow the other.
Potentially more common than not, people complain of their shoulder pain having started for no apparent reason. Just because there is no major traumatic event, that does not mean that shoulder can’t still be injured. Repetitive overuse, posture, and muscle use imbalances can contribute to micro trauma and tendinitis, spasm, or the development of trigger points of the shoulder muscles.  Arthritis or degeneration of the joints are also causes of gradual onset shoulder pain. Shoulder and upper extremity pain can also be referred or radiating from the neck. As you can see there are many different parts that have to be able to work appropriately together for optimal, painfree shoulder function.
If you or someone you know is experiencing any kind of shoulder pain, don’t hesitate to ask a physical therapist for help. Our thorough examinations can help determine where your pain is coming from and what factors are likely contributing to your pain. After an examination, the physical therapist can then prescribe treatments to address any deficits in posture, flexibility, soft tissue mobility, strength, and stabilization. The sooner treatment is initiated, the better, as minor inflammation or minor tears can become worsened if aggravating factors are not addressed. Shoulder pain can commonly affect ability to sleep, ability to perform dressing or bathing tasks, can contribute to difficulty with overhead reaching, reaching behind the back, and difficulty with lifting or carrying things. Don’t let your shoulder pain limit you from these activities or anything else you enjoy doing.