Shoulder Pain: Why they’re aching
Have you ever been training in the gym and you start to get this dull ache in your shoulder? And if it’s really bad it runs down your arm? Or sitting at your desk, working away and this nagging pain starts and it won’t go away?
I’ve had this problem. It’s very frustrating and can bring training to a complete stop. Shoulder pain and problems are common amongst people competing at the highest levels of their sports to people just going about their daily lives. I’m going to explain probably one of the most complicated areas of anatomy as simply as possible.
Read: 5 mins
Table of contents:
1) How the shoulder moves
2) Why does it hurt?
3) How to Manage
4) References
1) How the shoulder moves
So the shoulder is known as a ball & socket joint. To give you an idea what that is, take your right hand and make a fist. Place that hand inside your left hand and move it around. This is what a ball & socket joint does; it has the most movement compared to other joints but in turn, then has the least amount of stability.
Our fist is representing our humerus which is the upper arm bone and our open hand is representing our scapula or better known the shoulder blade.
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We have a lot of things happening around our shoulder; muscle attachments, nerves, ligament attachments and a whole bunch of other things and with the amount of movement we can produce, it’s easy to see how something can get damaged or aggravated in some way.
We have quite a few movements our shoulder & shoulder blade can perform:
Shoulder joint: Flexion, extension, abduction, adduction, internal & external rotation.
Shoulder blade/Scapula: Elevation, depression, adduction, abduction, upward rotation, downward rotation, protraction & retraction
2) Why does it hurt?
It’s important to not self-diagnose as pain can be anywhere but originate from somewhere else. When we don’t look after our muscles through various prehab exercises, they can start to behave differently and can affect our ability to function in our daily routines or training.
The most common issue among people is a lack of stability in the joint. We have a series of deeper muscles that attached our shoulder blade to our arm and are designed to increase the stability to the joint.
Back of shoulder
Front of shoulder
When we perform our sport or certain movements (eg placing something on a shelf) over & over again, without that stability and strength in our rotator cuff and surrounding muscles, we can develop overuse injuries (eg tendinopathy).
| Table 1 Causes of shoulder pain | ||
| Common | Less Common | Not to be missed |
| Rotator cuff: | Rotator cuff: | Tumors (bone tumors in the young) |
| · Strain | · Tear | Referred pain: |
| · Tendinopathy | · Calcific tendinopathy | · Diaphragm |
| Glenohumeral dislocation | Adhesive capsulitis (frozen shoulder) | · Gall bladder |
| Glenohumeral instability | Bicep tendinopathy | · Perforated duodenal ulcer |
| Glenoid labral tears | Nerve entrapment: | · Heart |
| Referred pain: | · Subscapular | · Spleen |
| · Cervical spine | · Long thoracic | · Apex of lungs |
| · Thoracic spine | Fracture | Thoracic outlet syndrome |
| · Myofascial structures | · Scapula | Axillary vein thrombosis |
| Fracture of clavicle | · Neck of humerus | |
| AC joint sprain | · Stress fracture of coracoid process | |
| Other muscle tears: | Levator scapulae syndrome | |
| · Pectoralis major | Glenohumeral joint arthritis | |
| · Long head of biceps | Brachial plexus | |
| Neuropraxia (“burner”) | ||
| Neuritis | ||
| “Causes of shoulder pain” (Brukner, P, 2012, pp. 345). | ||
3) How to Manage
It’s really important If you don’t know what the issue is, go see a physio or exercise physiologist who will at least help you work out where the pain is coming from. With my shoulders, I thought it simply my pecs were pulling on my arm causing pain down my bicep. After speaking to my physio friend Corey (Check out his awesome tool the Body spanner), he performed some movement tests on me and we worked out it was coming from my upper trap and that has helped me big time.
The key is:
Correct diagnosis.
Regular remedial or self-massage.
Shoulder stability exercises.
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4) References
Brukner, P. and Khan, K., 2006. Clinical sports medicine.
Ben Kibler, W., 1998. The role of the scapula in athletic shoulder function. The American journal of sports medicine, 26(2), pp.325-337
