You may have shoulder pain when you move your arm above your head or into a particular position. Working out what is contributing to your pain experience is the job of a skilled MSK clinician. The shoulder is linked to the pelvis and the thoracolumbar junction (thoracolumbar syndrome) and connects with the flexibility of the psoas muscle.

Pain under the shoulder blade may not be a shoulder issue at all even though pain is felt in the shoulder region. Of Course, concerns with the shoulder can arise from the anatomy of the shoulder. The painful arc is usually present when the arm cannot be lifted above shoulder height comfortably and easily.

The painful arc alludes to a dysfunctional movement known as impingement movement of the shoulder (1). When pain is present as well as an impingement type movement then you’ll have a SAPS (Sub-Acromion Pain Syndrome) (2). The Rotator Cuff muscles of the shoulder may be involved in SAPS syndrome.

Dysfunctional movement of the shoulder can be part of a wider body dysfunctional movement (3) known as a Category II Dysfunction. In this instance the shoulder is the compensation (help) strategy of the body. Trying to resolve the shoulder without addressing the whole body weight bearing dysfunction becomes fruitless.

At Fascia First Chiropractic where shoulder discomfort and pain are concerned, we look at shoulder anatomy, shoulder movement, whole body posture, as well as spine and pelvis function, all in the first session. Getting your shoulder better could mean exercises and manual therapy over a 120 day time-frame.

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References:

1. de Witte PB, Nagels J, van Arkel ER, et al. (2011) Study protocol subacromial impingement syndrome: the identification of pathophysiologic mechanisms (SISTIM). BMC Musculoskelet Disord 12:1-12.
2. Diercks R, Bron C, et al (2014). Guideline for Diagnosis and Treatment of Subacromial Pain Syndrome. Acta Orthopaedica. May 21;85(3):314.
3.  Park SW, Chen YT, et al (2020). No relationship between the acromiohumeral distance and pain in adults with subacromial pain syndrome: a systematic review and meta-analysis. Scientific Reports. Nature. Nov 26;10(1):1-4.