I’m going to be honest.
Years ago, when I first started treating patients, chronic shoulder pain used to be one of the most difficult symptoms for me to treat.
For a lot of therapists, chronic shoulder pain that won’t go away is one of the most frustrating symptoms to help a patient with. And in my experience, exploratory surgery for shoulder pain is one of the most overrated and wasteful uses of healthcare resources there is.
So why can shoulder pain be so much of a challenge?
The answer is that it is one of the most complex joint(s) in the body. The shoulder consists of three bones that intersect in multiple places. The Humerous (upper arm bone), Scapula (shoulder blade) and Clavicle (collar bone).
It has multiple ligaments that hold the bones together and even more muscles and their tendons that attach to the bones that help create movement.
These muscles and tendons are placed in ways to allow for movement in all three planes of motion.
But more than that, quite a few muscles of the neck, also attach to these bones that form the shoulder joint. So not only is movement at the shoulder a balance of efficiency of the muscles that from that area, but also strongly affected by how the muscles and movements of the neck are working.
And you can go even further and acknowledge that some of the muscles of the shoulder connect to the rib cage as in the serratus anterior and subscapula. But also the soft tissue of the lower back in the case of the latisimus dorsi. So it’s reasonable to believe that when there are sensitivities or tonic changes to function at those areas, those too could also affect how your arm moves around in the shoulder joint.
These are examples of the types of variables that your therapist needs to go through and explore to see what may be causing your pain. If you don’t know which of these areas are contributing or at least have a plan to work out which areas are the prime reason for your pain, then getting a resolution from your pain will be more luck than by design. And more than that, will take a lot longer to find any sort of resolution.
This is why our Four Step-Treatment Process was designed and why the bulk of the work that we do in clinic is assessment based aimed at finding the root cause of pain or other issues.
Chronic shoulder issues are no longer the mountain they used to be. Yes they can be complicated in that there can be many different factors contributing to your pain, but experience and a system designed to cater for all possible causes, helps us narrow down the options. Getting you back to your normal life, pain free, fast.
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