Patients complain about shoulder pain at the end of their golf swing. When I ask them to demonstrate, they slowly go through the swing, pausing a little extra at the end to produce the pain. Sometimes, they will not get the pain unless they make the motion fairly quickly.
Illustrations usually show this pain as happening in the front. However, most patients say it feels like it is in the joint and in the back of the shoulder at the end of the golf swing.
When acutely aggravated, the pain extends down the arm and can weaken the grip. This weakness may cause the club to fly out of their hand at the end of the swing. These people may also fumble their coffee cups or cocktails at the clubhouse.
There is usually a complaint of tension in the top of the neck when asked, but then the patient will dismiss this as “normal pain.” Also, they commonly have some stiffness in their back that limits the golf swing and forces them to extend the shoulder around a little more at the end.
Some patients complain of pain in the shoulder when starting their swing, but it isn’t as common. They have typically learned to slow their wind up, especially at the beginning of their game. Many of them have a set of exercises that their therapist gave them to warm up for golf. These exercises offer temporary relief but don’t fix the shoulder.
These tests will produce pain and restricted motion when the trigger points in the infraspinatus are active.
The first test involves placing the forearm across the lower back. It usually produces pain in the shoulder, which worsens as you reach up the middle of the back. Notably, this may also indicate trigger points in the coracobrachialis with a different pain pattern.
In the second test, reach around the back of your head like the pic. When the trigger points are active, it is restricted and painful. Also, you cannot contact the edge of your mouth without pain and stiffness.
By the way, this is a rotator cuff problem, and you should get some bodywork. Don’t just stretch it out before every game or “tough it out.” This problem usually gets more disabling and expensive to handle. An experienced massage therapist or physical therapist can help you.
The patient might additionally complain about pain in the shoulder while sleeping. Much of the time, if the person is complaining about the golf swing, then we’ll find that their sleeping position has been adjusted to avoid the shoulder pain created by this trigger point.
The situation may also be aggravated by reaching to the back seat to tend to a child or to retrieve a bag from the floorboard. Reaching back to tuck in the shirt or fasten a bra usually hurts as well. We then learn to put on a shirt or jacket without reaching back too far.
The self-care post has more ideas on what you should do to care for this.
This post on anatomy contains standard information about the origin, insertion, function, and innervation of muscles. Additionally, it includes information on functional considerations and anomalies.
Anatomy posts have a grid of all related posts. This includes posts on pain patterns, self-care, therapy notes, NMT protocols, cranial techniques, and cases.
Self-Care Posts have common sections to make them easy to follow and understand:
Therapy Notes provide details for cranial, spinal, and local joint work. These notes also link to a traditional neuromuscular protocol.
By treating integrative components first, direct work on the muscle becomes less intense while providing longer-lasting relief.
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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written materials and instructed classes since the mid-90s. This includes anatomy, trigger points, cranial, and neuromuscular.
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