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There are several common reasons why you may suffer from shoulder pain. The first is due to the pinching of a tendon between two bones. This occurs when you try to lift your arm to shoulder height or above. In a ‘normal’ shoulder the tendon in question fits neatly between these two bones and movement is free and normal in all ranges. However, when this tendon becomes inflamed due to trauma (such as a fall onto the shoulder) or repetitive strain then the inflammation makes the tendon thicker. The thicker tendon no longer fits well between the two bones, and so when you move your arm to shoulder height it gets squashed, causing you pain. This occurs commonly through activities where there is repeated overhead work, such as tennis, factory work, gardening, etc.

The second major reason why your shoulder may suffer from pain is due to a condition known as frozen shoulder. In a nutshell, frozen shoulder is what occurs when all movements of your shoulder joint are extremely limited– particularly when bringing your arm away from your side. This is accompanied by pain. The reason this occurs is still unclear, but the commonly accepted diagnosis is the ligaments that surround the joint and form a capsule around the joint become stuck to themselves. This leads to a greatly reduced range of movement of the joint – ‘freezing’ the joint.

There are of course many other reasons for shoulder pain. These include pain that is referred to the shoulder from the neck, elbow or wrist. Pain in the shoulder may also be due to dysfunctional muscles or strained tendons. But whatever the reason it is important to ask why the shoulder pain has occurred in the first place.

If there has been no direct trauma involved, then it is important to consider your shoulder posture. In everything we do we have our arms in front of us – eating, working, driving, etc. and this leads to us habitually rolling our shoulders forward. You only have to look at the people around you to see that most of us do not sit or stand with our shoulders back and down in the correct anatomical position. What this does is cause the mechanics of the shoulder joint to work incorrectly. Muscles then need to work harder and joints don’t glide over each other as they are intended to. As an experiment, roll your shoulders forward and with your shoulders in this position lift your arms so they are pointing to the ceiling. Do it first with your arms coming out to the sides and then out to the front. Remember what this feels like. Now sit up straight with your shoulders back and down, and then do the same movements. You should notice that the movements are easier if the shoulders are back and down.

Now imagine how much more effort is required to live life with rounded shoulders. Every day, day after day, doing activities that lead to loading up of the shoulder joint and surrounding muscles. This inevitably leads to shoulder dysfunction. It sounds simple, however most people never realize that they are rolling their shoulders forward.

Try to think about holding your shoulders back when you walk, when you are at work, etc. This will, over time, improve your overall posture and also help with any neck problems you may have. Remember, good posture is about making yourself gravity resistant. If your shoulders roll forward then gravity wants to keep rolling them further forward. Do not allow this to happen! Hold yourself up straight and remember to hold your shoulders back in a neutral position. Good luck!

Next time, we discuss lower back pain…

Stuart Hicks
Myotherapist (Adv. Dip. of Myotherapy)
stuie_1@hotmail.com