Relieving shoulder pain requires a careful, thorough approach for this complicated joint. The shoulder moves more freely than any other joint in the human body, and more than a dozen muscles govern both its movement and stability. Whether dealing with tendonitis, arthritis, or mild tears of the rotator cuff, successful treatment of most shoulder problems requires treatment that restores muscle function and balances tension around the joint.  

Restrictions in the connective tissue called fascia, usually caused by prior injuries, are often the cause of shoulder muscle dysfunction. Finding and treating these restrictions can restore muscle balance and strength, which helps relieve shoulder pain.  

To better illustrate the complexity of shoulder issues, let’s look at the cases of three patients of mine, whom I will refer to as Pat, Larry, and Sue. Pat could not raise her left arm to her head, resulting in a tendonitis diagnosis. Larry could not reach behind him or even into the back seat of his car.  He was told that he had bursitis in his right shoulder.   

An MRI of Sue’s right shoulder revealed a small rotator cuff tear.  She was unable to lift a coffee mug or drive her car without intense pain. Each of these three patients had different problems, but the roots of their pain could be traced back to fascia, a fibrous connective tissue that covers muscles, nerves, bones, joints, and most other tissues in the body.    

Tendonitis 

Pat’s tendonitis occurred because lifting her arm caused a tendon to pinch. An examination showed that her latissimus dorsi muscle (which is the largest shoulder muscle) was contracted and overly tight whenever she lifted her arm. This caused the joint to align incorrectly while in motion, which caused the pinch.   

Pat required fascia treatment in her low back area, which is where the latissimus muscle is anchored. There were also restrictions in the fascia of the left side of her rib cage, and her left biceps muscle. Along with fascia release therapy, she was also given a specific massage therapy to coincide with treatment to her low back area.  After a few weeks of treatment, she was able to raise her left arm as high as the right with comfort and ease.    

Bursitis 

Larry could not reach behind him due to tension in the pectoral (chest) muscles and fascia restriction at the front of his shoulder joint. These issues were likely caused by a hard fall onto concrete two years prior, which resulted in shoulder pain for several weeks. The resulting muscular imbalance eventually led to inflammation and pain in a fluid-filled cushion of tissue called a bursa. This caused pain in the restricted motion of the shoulder. 

While treating Larry’s pectoral muscles and right shoulder joint, fascia restriction in his thoracic spine (mid-back) also has to be released. As we continued with treatment, he achieved full range of motion without pain. However, I warned him to stop reaching behind him from the front seat of his car into the back to grab his briefcase. That position is unnatural and stressful to the shoulder and was causing repetitive re-injury each time he performed it.  

Rotator Cuff 

For Sue, her shoulder movement was weak and unstable due to uneven tension and weakness of muscles around her shoulder blade.  Sue’s pain built gradually over several months, rather than making a sudden appearance. The instability and awkwardness in her shoulder movements caused incremental degeneration that led to a rotator cuff tear. 

Sue’s primary issue was in the serratus anterior muscle under the shoulder blade. She also had restricted fascia at the base of her neck and down her triceps. In addition to treatment with fascia release therapy, Sue learned how to do specific shoulder stretches and exercises to accelerate healing and prevent re-injury. After her treatment was complete, Sue could drink her morning coffee and drive without complaint. She still had to avoid strenuous lifting due to the rotator cuff tear, but she had no problems with normal daily activities.    

Solving the Problems 

The solutions to these three different problems shared one common thread—the need to restore muscular balance and stability to the shoulder.  This was achieved by using specific therapy to release restrictions in the fascia. This kind of fascia release for muscles of the shoulder often relieves pain, even when there is a minor tear or other injury.  In the cases of Pat, Larry, and Sue, all three found significant relief and the ability to return to their daily activities.  

The Common Thread 

No two shoulder problems are exactly the same.  However, almost all issues with the shoulder can be improved by restoring muscular balance and stability to the joint. There are many integral parts to a successful shoulder treatment plan, including stretches and strength exercises. The treatment that I usually find most critical is fascia therapy because restrictions in fascia are often the main cause of muscle weakness, tension, or imbalance.   

When fascia therapy is combined with other treatment methods to restore muscular balance and control of the shoulder joint, many types of shoulder pain can be soothed or relieved entirely. This is even true when shoulder surgery has failed to resolve shoulder pain, or has created new pain due to scar tissue.    

Dr. Eric Winder, D.C., uses gentle manual therapy and rehabilitation techniques to help patients with a wide range of pain and injury problems. For more information, call 941-957-8390 or visit https://gentlebay.com/