Shoulder pain can occur for a variety of reasons, it may come on gradually as a generalized aching in the shoulder itself, tightness in the neck and shoulder muscles, or damage to the tendon, ligaments, or bone from an injury (like a fall, or an athletic injury). There may be associated neck and/or arm pain, numbness or tingling in addition to the shoulder pain.
Shoulder pain can be the result of injury to tendons, joint capsule (such as labrum), muscle/tendon (such as the rotator cuff group), or bone(fracture) which will typically be determined via diagnostic imaging such as MRI or X-ray. However, shoulder pain can also be the result of altered biomechanics in the shoulder itself, in the neck, upper thoracic spine or the arm, which may be creating abnormal changes in the recruitment of the joints and muscles that are required for proper function. Prolonged positions such as sitting at a desk/computer, reading/writing, prolonged time driving in the car, places stress on the cervical and upper thoracic spine, and the region known as the shoulder girdle (which includes the scapula, clavicle, first rib, and humerus, and the associated muscles trapezius, levator scapula, supraspinatus, infraspinatus, teres major, teres minor, subscapularis, pectoralis, rhomboids major and minor). Forward head posture, anterior shoulder carriage, and any other changes in normal joint mechanics lead to overcompensation by some muscles (tightening) and weakness in others, which will stress the joint and lead to injury and pain. Many times, when a person has suffered from multiple injuries (overuse injuries) to the shoulder such as tendinitis or multiple tears, there is also a neurological component that is creating the pattern of injury, not just a simple “clumsiness” or “predominance” for hurting that joint, because the body has adapted to the abnormal signaling from the region and has not altered its signaling back down to accommodate for that.
After thorough examination by Maine’s only Chiropractic Neurology team, we will determine if the source of your symptoms is biomechanical (postural strain, improper joint and muscle biomechanics), neurological (inappropriate neurological control of the muscles and joints of the region) or pathological (tendon or muscle tear, bone fracture, labral tear, all usually confirmed via appropriate imaging). With a pathological source of pain we will refer you to the appropriate provider who specializes in treatment of such conditions, and may co-treat with them if there are associated structural/biomechanical or neurological components contributing to the injury. Biomechanical and neurological based shoulder pain is treated in our office with the purpose of retraining those joints, muscles, and neurological pathways that have been interrupted in signaling. This is accomplished via chiropractic adjustments, neuromuscular re-education, kinesio taping, neurological retraining to cerebellar and cortical regions, cold laser therapy, and therapeutic exercise specifically focused on improving strength in weakened muscles and stretching overused muscles.
