Your Pain Pattern,
What Aggravates It,
The Underlying Anatomy
How to Get relief,
How People Describe This Pain Pattern
When the trigger point is less advanced, people hold their arm out with the elbow away from their side, reach around to touch the back of the shoulder behind the arm pit and say that it hurts there. If I ask if they can reproduce the pain, they cautiously rotate their hand back to a throwing position to demonstrate and wince.
This trigger point will ruin a pitcher. I treat a 40ish man who lost his career in the minors and could not even throw a ball with special needs children because of this. He’s throwing again.
In more advanced stages, they cannot lift the arm to the side at shoulder level. They have often been diagnosed with “Frozen Shoulder.” These people have adapted their routines to accommodate their inability to raise their arm for activities like putting on a shirt and reaching up to get something out of a cabinet.
When the shoulder pain is very bothersome, and I ask about the wrist, they usually have pain or sensitivity at their wrist.Some people will say that the wrist does not bother them but will scratch it or rub it occasionally as I work with them. (Trigger point referral is not always pain.)
How You Activate and Intensify This Pain Pattern
When this is severe, this creates a frozen shoulder, and it is hard to lift the arm to shoulder level. It takes a severe jerk upward, like grabbing a ledge to support your falling weight, to irritate this trigger point.
When this is moderately severe, it takes reaching up and back like winding up to pitch or reaching up and back to change a light bulb to aggravate this. If the tendon is sprained, jerky or sudden motions like this can make it more severe. Swimming and playing volleyball are also aggravating.
Prolonged immobilization with the arm turned in, as when you wear it in a sling leaves this muscle shortened. It is common to deal with this problem a bit afterward, especially if you sleep on that shoulder. Gentle stretching helps to speed the recovery.
When it is less severe reaching out while reaching up of back acivates this trigger point. It is common to aggravate it while reaching to the back seat to get a bag or tend to a child. The weight of the bag tenses the bicep which creates more stress on this tendon.
I have a trash can like the one in this picture. It is in my car but it sits in the middle of the back seat floorboard. It doesn’t bother my shoulder when I reach back with my palm facing back. Reaching back and up to turn off the rear dome light can create this pain.
The Musculoskeletal Anatomy Behind Your Pain
Anatomy – Throacic Outlet
The anatomy of these structures is important to understand the syndrome. This post walks through the structures one at a time.
This post on anatomy contains the standard information about origin, insertion, function, and innervation. It also includes information on functional considerations and anomalies. This is also the place to find all posts related to this muscle.
Getting Relief on Your Own
This post has strategies for getting relief on your own. Explore how to change your activities, stretch, and other strategies that relieve the pain associated with this trigger point.
Therapy Notes for Massage and Bodywork
Through Shared Expertise.
This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.
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Does Your Shoulder Hurt From the Covid-19 Vaccine?
This post offers quick, lasting relief from the pain in your shoulder that came from the vaccine. You will need an ice cube and about 2 minutes.
Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.
*This site is undergoing significant changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistencies in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.