Here's a clue, it may not begin in the shoulder!
Unless there is trauma or injury to the shoulder, in my experience, 80% of shoulder pain begins in the neck.
Usually, swimmers and other athletes develop shoulder problems due to trauma or repetitive motion; but the average person who develops a shoulder problem, has developed it before they realize they have it. In order to understand the process that causes the pain, we need to understand the anatomy of the shoulder.
Unlike other joints in our body, shoulder stability comes from muscle integrity. The shoulder is held together mostly by muscle and little ligaments and tendons. Because of this design, the shoulder has greater range of motion than any other joint in the body. The stability of the shoulder depends on muscle balance. For example, the muscle that pulls the shoulder forward and the muscle that pulls the shoulder back must work in perfect synchronicity. People who lift weights and work to increase the size of their chest muscles will eventually end up with rotated shoulders towards the front because the shoulder muscles are out of balance. But athletes and trainers know better and make sure to work out both sides of the shoulder to create balance. If you are weight training, we recommend that you do it with a trainer who knows what he/she is doing. A trainer knows to work out a group of muscles rather than only individual muscles. This is especially true for the upper body as it all affects the shoulder joints.
Sometimes we create imbalance by irritating the nerve that goes from the neck to the shoulder. Almost all the muscles in the shoulder are controlled by nerves that come from the neck, otherwise known as the cervical vertebrae. When the neck vertebrae are misaligned and press on the nerves, it causes muscle spams on one muscle group; over time that spasm turns into muscle atrophy. When there is a spasm in the front or back of the shoulder it slightly moves the shoulder out of place. This phenomenon happens long before a person feels discomfort in the shoulder; sometimes years can go by before a person feels shoulder pain. This happens when a person has neglected their neck pain. I see this happening primarily in people who spend long hours sitting in front of a computer.
When people come to my office with shoulder pain, I treat their neck vertebrae simultaneously with their shoulder joint, unless it is a case of trauma directly to the shoulder as in a car accident or sports injury.
So next time you feel shoulder pain, visit your chiropractor and ask him or to check your neck as well as your shoulder joint.
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