Getting to the Bottom of Shoulder Pain

Shoulder pain can be acute or chronic, a bit of a niggle, or excruciatingly painful.

It’s a complex joint, with a lot going on structurally and a good number of muscles acting upon it, meaning that addressing shoulder pain is not always straightforward. So what can you do?

Explore the shoulder with us to understand pain and shoulder discomfort better.

The shoulder is an incredibly mobile joint, but as with most things in life this benefit comes with a trade-off - stability is sacrificed for mobility in this high-functioning joint. It is common for pain to come from a lack of shoulder strength, so making sure your shoulder complex is strong is a great start to help mitigate shoulder pain.

The shoulder is made up of three true joints;

  • The Glenohumeral joint, where the humerus connects with the scapular (shoulder blade) is a ball and socket joint

  • The Acromioclavicular (or AC) joint, which connects the scapular to the clavicle (collar bone).

  • The Sternoclavicular joint, where the clavicle connects with the sternum (breast bone).

Only one of these joints, the Sternoclavicular joint connects the arm to the skeleton of our body (the axial skeleton), so we have the clavicle, shoulder blade, and arm, plus all of their muscles hanging from this one joint.

There is also a fourth joint called the scapulothoracic joint, this isn’t a real joint, but it can be thought of as a joint as it allows movement, it’s where the scapular moves against the thoracic (rib cage).

There are a lot of parts that make the shoulder work, helping it to be so versatile, but also problematic. Unlike most other joints, there is no solid bone structure that provides support and so the shoulder uniquely relies on muscles and soft tissues for keeping the joint stable.

You can find at least 19 muscles acting on the shoulder. Most of us would only know a handful of these;

Trapezius, Supraspinatus, Infraspinatus, Teres Major, Teres Minor, Latissimus Dorsi, Biceps, Triceps, Pectoralis Major, Pectoralis Minor, Subclavius, Serratus Anterior, Deltoid, Subscapularis, Sternocleidomastoid, Levator Scapulae, Coracobrachialis, Rhomboid Major, Rhomboid Minor

Because of the mobility of the shoulder, the muscles have a big job and unfortunately, our lifestyles do not help them out. We rarely reach up anymore and swing from bars, instead we live our lives with our arms out in front of us, typing on a keyboard or a phone. Almost all of us are constantly using the same muscles in front of us, and neglecting the shoulder muscles at the back.

This contributes to the joint, not surprisingly becoming unstable and poorly loaded. The muscles we use most regularly become overloaded as they make up for those we’ve allowed wasting away. This causes a vicious cycle of pain derived from both overuse and seldom use - when we do need to engage one of the less called-on muscles.

The most simple way of avoiding pain and injury is ensuring that all the muscles working around the shoulder are fit for their function. Strengthening the entire shoulder complex with simple, lightweight exercises is the best way to start. We will talk about some of these throughout the month, or you can head to our Exercise Library for a head start.

We do advise you to speak to a specialist prior to commencing any shoulder exercises as we all have different abilities and exercises that work for some people may not work for others. Creating awareness around which muscles you are engaging (your dominant muscles) and which need some strength work is the best place to start.

You can seek out a personal trainer, physiotherapist, exercise physiologist, or come and see one of our trained Remedial Massage therapists for a full, personalised soft tissue assessment, and exercise plan.

The big tip we’d like to leave you with as we start out Shoulder Month is to keep it light!

As soon as you try to lift heavy weights, you’ll start recruiting your dominant muscles and exacerbating the problem. Start light and don’t rush into lifting heavy weights - It shouldn’t hurt!

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