Is Your Shoulder Blade Causing Shoulder Pain?
Ever sit in an office or ER for hours?
Once you’re seen.
Here’s how things would typically go:
- See MD
- Get X-RAY/MRI (exposure to radiation)
- Get drugs or injections to manage pain.
- Get surgery (if something is damaged)
- More drugs.
How about Physical Therapy?
In Physical Therapy and Orthopedics we learn about “sick scapula syndrome” also known as scapular dyskinesia. Basically, your shoulder blade position is causing shoulder. Right? Wrong.
Recent research tells us 3 things:
1) Of all the people studied with poor scapular positions: about 60% have pain in the shoulders and the other 40% is fine.
2)Everyone’s shoulder blade can be different in shape and position.
3) The shoulder blade does not tell the whole story.
Research is Not Law. It’s a Starting Point
When we talk about the shoulder joint, we only think about your humerus (arm bone) and your scapula (shoulder blade).
Did you know your shoulder is actually made up of 4 joints? I hope your doctor does.
Those joints are:
- Glenohumeral (shoulder joint)
- Acromioclavicular (roof of the shoulder)
- Sternoclavicular (where your collarbone meets your neck)
- Scapulothoracic (the shoulder blade and mid-back)
Your shoulder is a COMPLEX!
Each joint has to work together in order for you to have the full range of motion when you move your arm.
What’s causing my shoulder pain?
If you’re feeling pain midway through the range of motion when lifting your arm, you’re probably pinching something in the shoulder. In the medical world, we call that impingement syndrome.
If you’re feeling pain at the top of your range of motion it could be your AC joint.
Your shoulder pain can also be coming from your neck or mid back.
It’s up to your doctor to figure it out. A skilled clinician will look at the spine/posture to make sure it’s not the root cause of your pain.
Sometimes, we forget that the thoracic spine (mid-back) is the foundation to your shoulder.
Your mid-back is designed to be FLEXIBLE. It’s where all the twisting and side bending happens in your upper body.
If your mid-back can’t move, then your shoulders take on the extra stress (or other parts of your spine such as your low back or your neck).
Would you build your house on a bad foundation? Probably not.
Here’s what I tell my patients (young and old):
“it doesn’t matter how strong you get shoulder. If your back isn’t strong, it’s like a pitcher pitching on ice.”
Try the scapular reposition test if you don’t believe me. Remember the concept of force couples in kinesiology class? That is all.
If you have supraspinatus (rotator cuff) muscle and/or biceps long head tendon damage, it usually means that your scapular thoracic joint is not doing its job.
Research has shown a stiff mid-back can lead to headaches, jaw pain, and even carpal tunnel syndrome.
The purpose of your rotator cuff muscles just keeps your humerus arm bone in place. It’s not supposed to do all the heavy lifting. You have way stronger and bigger muscles in the back to do that.
The reality is most medical professionals get pigeonholed two the site of pain. My question as a doctor is what is the root cause of that pain in the first place.
Think globally and not locally.
Curing the pain is important, preventing you from coming back as critical.
Most professionals believe shoulder pain is usually due to imbalances in your joints/muscles around your shoulder.
- If your mid-back doesn’t move your shoulder blade can’t either.
- If your neck is stiff, your collar bone can’t move (then you lose 10 degrees of motion).
- What about the muscles? That’s what holds your shoulder all together! If you’ve had patients or are a patient that has pain that starts from a shoulder going into your arm/hand then you have muscle issues.
Here are a few tips if you have shoulder pain:
- Ask your doctor (orthopedist/physical therapist) to look at your neck and your mid-back mobility.
- Lower the weights with upper body workouts (if it’s too heavy you skip over all the important stabilizing muscles. Control is more important)
- Don’t completely rely on pain or anti-inflammatory medicine. They have their place, but medicines wear off and the pain comes back.
- Sleep with a pillow between your arm and your body.
- If you have to pick something up, BEND your elbow.
- See a Doctor of Physical Therapy work with your MD