Shoulder Pain Reasons & How We can Help…

Anatomy of the Shoulder

The shoulder is a very complex joint. It has many muscles, ligaments and nerves that go through and attach to the joint. This complexity is what allows the shoulder to be the most mobile joint within the body. Unfortunately though, this increase in mobility can make the shoulder susceptible to many types of injuries. Understanding shoulder pain reasons is crucial, as they can range from overuse injuries and rotator cuff tears to arthritis and nerve impingements.

Bones of the Shoulder

Scapulae (shoulder blade)
Clavicle (collarbone)
Humeral head (upper arm)

Muscles of the Shoulder

Teres minor
Teres major
Pectoralis minor
Pectoralis major
Levator scapulae
Latissimus Dorsi

Nerves that Supply Each Muscle


Range of Motions of the Shoulder 

Internal rotation
External rotation
shoulder pain reasons

Shoulder Pain Reasons

As mentioned above, the increase in mobility within the shoulder leaves it vulnerable to many types of injuries. The most common type or most spoken about is a “rotator cuff strain or tear”. The rotator cuff is a group name given to combine the four muscles that help rotate the shoulder. These four muscles are the supraspinatus, subscapularis, infraspinatus and teres minor. You are at a 61.9% (if male) or 38.1% (if female) chance of injuring the supraspinatus over the other three rotator cuff muscles.

  • Rotator cuff strain/tear
  • Frozen shoulder
  • Bursitis (Inflammation of the Bursa)
  • Tenditis (Inflammation of a Tendon)
  • Calcific Tendinitis
  • Dislocation
  • AC joint compression
  • Impingement (compression of muscle or nerve)

Common Presentation

Patients with shoulder pain often present to us with a “dull”, “constant”, “hard to pinpoint”, “ache”, down into the upper arm specifically around the tricep and deltoid area. It is quite common for shoulder injuries to refer as pain and/or tightness down into the upper arm and elbow. Patients will present with restrictions in certain range of motions.

It’s common to find weakness in more than the one of the muscles due to how the body compensates. The surrounding muscles will compensate to take over the load of the affected muscle or ligament. We also find that our patients will have a restriction or instability within the pelvis on the same side of the affected shoulder.

Do any of these descriptions sound like you? Keep reading and find out how we go about treating the shoulder and how you can get in touch with us…

Problems with Imaging

Imaging has come a long way and is no doubt a great tool to the health profession, but not everything is always as it seems. Let me show you why…

MRI research results for people with NO SHOULDER PAIN showed:

  • 40–60-year-olds – 4% had a full thickness tear and 24% had a partial thickness tear.
  • 60 years old+ – 28% had a full thickness tear and 26% had a partial thickness tear.
  • Over half the population who are 60 and older have some form of tear within the shoulder.
  • 2/3 of rotator cuff tears don’t cause pain. If you have pain & get an MRI or ultrasound, just because a rotator cuff tear showed up doesn’t always mean it caused your pain, or that you need surgery.

Asymptomatic tears are twice as common as symptomatic ones. It’s easily possible, then, to have a rotator cuff tear with no shoulder pain or other symptoms at all. In fact, it’s the most likely situation. The problem with referring for imaging for specific shoulder injuries is that it can lead the patient down the path of ‘nocebo’, being the opposite of placebo. Nocebo is when a patient develops side effects or symptoms that can occur with a drug or diagnosis just because the patient believes they may occur. Therefore, referring for imaging can potentially have a negative effect on the treatment process and outcome.

Healing Time Frames

Is a Corticosteroid Injection a Good Idea?

Research shows that corticosteroid injection is quite varied on the time it gives the consumer for pain relief. While someone you know may have received 3-4 months relief, others can experience only a couple of days (7). The evidence shows that corticosteroid injections were more effective in reducing the pain score at 0 to 8 weeks, but there was no difference between the injection group and the non-injection group at 9 to 24 weeks (8). It also states that there is a lower complete recovery or improvement at the 1-year mark in the injection group (9).

Not only is there a significant financial cost that comes with getting the injection, but there is also the risk of weakening your tendons, accelerating joint deterioration, tendon degeneration and cartilage deterioration within the joint (10).

Given the discomfort, cost, and potential to accelerate tendon degeneration associated with corticosteroids, they can have limited appeal.

Conservative Care vs Surgery

The shoulder is very important to our day-to-day function and if you have ever had a shoulder injury, you’ll understand how debilitating it can be. As the shoulder is so complex, people often feel there’s ‘no cure’ or they just have to ‘live with it’. People will also look for the quickest solution.

If you’ve been diagnosed with a rotator cuff tear or shoulder impingement, you may have been told to do two things:

  • Restrict your activities;
  • Book in for surgery as that’s the only option for properly fixing your shoulder.

Research shows that surgical intervention did result in a small statistically significant but clinically unimportant improvement in long-term functional outcomes. Further evidence suggests surgical intervention has little, if any, benefit for impingement pathology.

Repairs for full thickness rotator cuff tears showed no clinical difference between surgical & non-operative management. The differences in VAS scores (6) were small and did not meet the minimal difference to be considered clinically significant.

How Can We Help

At Blue Align Chiropractic, we take a spine-out approach, following the nerves out to the muscles and organs.

We understand that the body can compensate in many ways, and then manifest itself in shoulder pain or breakdown through a shoulder injury. That’s why we aim to find those underlying weaknesses and address your body as a whole. We will address your shoulder but also strengthen and stabilise your underlying weaknesses. 

  • We will use orthopaedic testing, muscle tests, neurological tests, postural analysis,and range of motion tests of the spine, shoulder and pelvis.
  • We will use specific spinal and pelvic chiropractic adjustments, to balance the spine and pelvis, and the surrounding areas related to the shoulder.
  • Mobilisation to help reduce pain by providing new brain stimulus to improve your confidence.
  • Muscle activation of the surrounding shoulder structures to balance compensations.
  • Cold laser treatment to reduce inflammation and promote tissue repair.
  • Exercise prescription that encourages you to move more.

If you have any further questions regarding the shoulder, feel free to give us a call on (07) 3357 3366 or send us a message on any of our social media profiles and we will help you find the answers you are looking for.

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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