A Holistic Approach to Shoulder Pain

Shoulder Pain

Shoulder pain can really disrupt your daily life. Everyday tasks like getting dressed or showering become hard, and simple movements like reaching in the car can cause sharp pain. Sleeping can also be difficult due to constant pain in the shoulder region.

The pain can also make you irritable with your family, and not being able to exercise can really affect your overall health.


Are you tired of living with shoulder pain that never seems to go away? It might be time to rethink how you take care of your shoulders.

We are in a unique time where modern science overlaps with ancient wisdom, offering a new perspective to revolutionise shoulder care.

This blog reveals crucial insights into shoulder problems and offers effective solutions based on this new understanding.

Diagnoses from MRIs and ultrasounds can create limiting beliefs that hinder healing, often leading people to choose riskier treatments like corticosteroid injections and surgery, which may not offer long-term benefits over conservative care.

Emotional states like anxiety and depression can be predictors of shoulder pain, complicating the recovery process. A holistic approach to treatment, which corrects whole body compensations rather than treating the shoulder in isolation, is more effective.

Scientific reasoning supports addressing postural and body compensations, as shoulder problems often stem from spinal issues affecting nerve signals. Chiropractic care and muscles techniques like Trigenics can correct these misalignments and restore proper nerve and muscle function, leading to true healing.

  • Holistic Approach: How Posture Affects Shoulder Healing
  • Breathing Patterns: Their Impact on Shoulder Pain & Wellness
  • Hidden Causes: How Your Spine Affects Shoulder Pain
  • Emotional Factors: How Anxiety & Depression Affect Shoulder Pain
  • Dangers of Diagnostic Imaging: How Negative Results Can Harm Recovery
  • Conservative Care First: Risks of Steroid Injections and Surgery

Holistic Approach: How Posture Affects Shoulder Healing

Understanding the compensations in our posture is crucial for healing shoulder problems. These compensations often contribute to the problem initially.

Take a look at Figure 1, which illustrates an example of spinal and postural compensation that can relate to multiple conditions beyond just shoulder problems. When the pelvis is misaligned, such as in this example (Category 2 – Pelvic Subluxation), it can lead to instability in the pelvic joints (sacroiliac) and irritation of the nerves, weakening the core and postural support below the shoulder.

This postural compensation causes the shoulder to roll forward into an incorrect position. As a result, the muscles in the shoulder are thrown out of alignment, making them more prone to sprains and strains, especially in muscles like the rotator cuff.

Additionally, this misalignment can cause muscles and ligaments to rub against the bursa, leading to inflammation and bursitis.

Interestingly, this same compensation can affect other areas of the body, such as the lower back, wrist, and elbow.

That’s why it’s crucial to address the compensation in the entire spine; otherwise, seemingly unrelated problems may arise.

Figure 1.

Many postural compensations like those shown above in Figure 1, can result in tightening of the diaphragm (part of our core muscles) which may result in restricted breathing patterns.

Breathing Patterns: Impact on Shoulder Pain & Wellness

An often-overlooked cause of musculoskeletal pain, including in the shoulder, is abnormal breathing patterns. These breathing abnormalities can develop slowly alongside postural problems, often accumulating due to stress.

Our sedentary lifestyle can also contribute to breathing problems, as shallow breathing and overuse of muscles like the upper traps and neck can cause tightness around the upper neck and shoulders. Shallow breathing restricts the diaphragm and can tighten the muscles of the chest, pulling the shoulder and soft tissue forward. This contributes to a similar problem described in Figure 1, where the shoulder is tipping forward on the right.

Breathing techniques are crucial for addressing shoulder problems and maintaining overall wellness by reducing stress. These techniques are easy to implement and can significantly improve health.

Our Advantage Lifestyle System includes effective, time-efficient breathing techniques that are essential for addressing many musculoskeletal problems, including shoulder issues, while promoting overall health.

How you breathe affects how well you move and perform. Strategies that sync your breathing with exercise help you move better and can even help your body heal faster. This is another example of how a holistic approach is so important in addressing any musculoskeletal problem.

Hidden Causes: How Your Spine Affects Shoulder Pain

IT’S NEVER JUST A MUSCLE PROBLEM!

The spine can sometimes be the overlooked culprit behind shoulder problems. It’s crucial to understand that while shoulder problems often seem like just muscle issues, they’re often just the tip of the iceberg. Muscles don’t act on their own; they’re controlled by our brain and nervous system.

Your nervous system is an incredible information super-highway. One thing that sets us apart from other species is that our brain has evolved enough to allow us to stand on two legs, and our ability to stand correctly uses a lot of brain power! The brain sends important messages through nerves to control our movements and posture, and these messages help all parts of the body stay in the right position, ensuring we maintain our balance and stand upright.

Under stress, the brain’s energy can be drained, leading to poor posture and alignment. Think of the spine as a fuse box. The spinal segments are like fuses; when they get overloaded with stress (physical, emotional, or mental), misalignments can occur, irritating the nerves that control the shoulder. If these nerve signals become inaccurate, it can lead to shoulder dysfunction.

Similarly, a shoulder problem can drastically affect your movement, causing secondary compensations and misalignments (joint dysfunction) of the spine. That’s why we take a holistic approach, addressing the entire spine and body in these shoulder issues.

Chiropractic techniques are effective in correcting spinal misalignments, restoring nerve flow and communication to the shoulder. This can improve not only shoulder function but also help the nervous system maintain the correct postural position of the shoulder. Additionally, when muscles around the shoulder become stressed (sprains and strains etc.), the flow of communication through nerves to the muscle can get blocked.

This is why we use a technique called Trigenics to work directly on the muscles, aiming to restore nerve communication within the muscle through the nervous system. Ultimately, the flow of energy and information through the nervous system is required for proper healing and restoration of muscle and shoulder function.

Muscles of the shoulder
Nerve location in the
spine that supplies each muscle
SupraspinatusC4-6
InfraspinatusC4-6
Teres MinorC5-6
Teres MajorC4-6
SubscapularisC4-6
BicepC5-6

Emotional Factors: How Anxiety & Depression Affect Shoulder Pain

Pain-specific fears, depression, and anxiety are now recognised as significant indicators of shoulder pain in research. It’s intriguing to discover that chronic pain is also linked to a phenomenon known as ‘right brain lateralisation’.

The right side of the brain plays a crucial role in processing emotions and monitoring bodily sensations. It’s also responsible for creativity and is often associated with musical and artistic abilities. This part of the brain tends to process information holistically, seeing the big picture rather than focusing on details.

When someone experiences chronic pain, the right hemisphere of the brain becomes more active, particularly in areas dealing with stress and anxiety. This heightened activity can intensify the perception of pain and prolong its duration. Understanding this connection enables the Chiropractor to design treatments that address these emotional components, potentially reducing pain levels.

Why Energy Therapy is Beneficial

The understanding of emotional influences highlights the importance of holistic treatments like energy therapy and mindfulness. These modalities help the nervous system see the broader perspective, facilitating healing on multiple levels.

In many healing traditions, shoulder issues are linked to carrying emotional burdens and responsibilities, akin to bearing the weight of the world. Integrated Energy Therapy, one of our specialties, draws upon these ancient principles. It teaches that suppressed emotions can become stored in the cellular memory of the shoulders.

Specifically, mental and emotional stress related to our perceived obligations can manifest in shoulder discomfort. The right shoulder symbolises self-imposed burdens, while the left shoulder represents external expectations. For instance, a mother fretting over her children may experience tension in her left shoulder due to the weight of her concerns.

Dangers of Diagnostic Imaging: How Negative Results Can Harm Recovery

Medical imaging like CT scans, MRIs, and ultrasounds are great for finding fractures, dislocations, and other serious issues. However, they can also be psychologically damaging when they reveal conditions like arthritis, tendon tears, or calcification around shoulder joints.

The nocebo effect is the opposite of the placebo effect. It happens when negative expectations or beliefs about a treatment cause harmful effects. This effect can slow down shoulder recovery and turn a problem into a chronic condition.

I remember when my wife had a frozen shoulder years ago, when our children were young. The scan results were so alarming that I wondered if she would ever recover. It seemed like every muscle in her shoulder was torn or damaged. She recently told me that she thought she’d never swim again, but she did.

A diagnosis can help us understand a problem, but it needs to be put into perspective. The issue is that a diagnosis can create a limiting belief about our ability to heal. This belief can slow down or even prevent healing, leading to a more chronic condition.

The reality is that findings shoulder imaging is often not related to the pain.

It’s so common for a person to think “I have had enough of this, I’m going to get to the bottom of it with a scan” (e.g. MRI, or ultrasound).

And here is what you need to know:

  • 2/3 of rotator cuff tears don’t cause pain.
  • MRI studies on adults with no shoulder pain found that 20% had partial thickness tears, and 15% had full thickness tears.

MRI studies on professional baseball pitchers found that:

  • 40% had a partial or full thickness tear in their rotator cuff and no pain while playing.
  • In a 5-year follow up, they were still pain free.

So, if you have pain and get an MRI, finding a tear doesn’t mean it’s causing your pain or needs surgery.

MRI of torn rotator cuff muscle – Supraspinatus

And the problem is that negative wear and tear findings on medical imaging tend to influence people toward drugs and surgical interventions rather than conservative care. This is because they think it’s too far gone.

However, this is often not the case when you compare long-term outcomes of conservative care vs drugs and surgery which are often no better in the long term.

Conservative Care First: Risks of Steroid Injections & Surgery

Conservative Care First!

There are some points to consider with corticosteroid Injections and surgery.

  • Corticosteroid injections come with the potential risk of tendon weakening and acceleration of joint degeneration (including osteoarthritis).
  • Corticosteroid injections can offer varied pain relief durations. While some feel better for months, others find relief lasting only a few days.
  • Studies show they can reduce pain scores within 0 to 8 weeks, but there’s no difference compared to non-injection groups from 9 to 24 weeks.
  • By one year, those injected show lower recovery rates.

Conservative Care vs. Surgery

Shoulder injuries can greatly affect daily life, leading many to seek quick fixes. Surgery may be advised for issues like rotator cuff tears or shoulder impingement.

Yet, research suggests surgery might offer only small long-term improvements. It may not be better than non-operative methods, especially for full thickness rotator cuff tears. Thus, deciding between conservative care and surgery requires careful consideration of potential benefits and risks.

The key message from research here is… try a conservative approach like chiropractic first, that includes exercise and manual therapy.


Summing up Shoulder Issues

Healing a shoulder problem requires understanding about how postural compensations contribute to these issues. Misalignments, like a misaligned pelvis, can cause the shoulder to roll forward, leading to muscle strains and inflammation. Breathing patterns can also affect shoulder health, as shallow breathing can tighten chest muscles and worsen shoulder alignment.

Holistic approaches, including chiropractic care, breathing techniques, and energy therapy, can address the entire spine and emotional factors, promoting overall wellness and reducing pain.

Imaging results can sometimes mislead, suggesting more severe issues than exist. Therefore, conservative care, such as chiropractic treatment and specific exercises should be considered before opting for surgery or injections.

DISCLAIMER: All content is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.

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