People complain of pain in their shoulder when brushing their teeth, combing their hair, putting on make-up, shaving their face, etc. The pain is usually described as being achy and deep in the shoulder. Their primary complaint may also include pain while carrying something by their side like a suitcase or bucket. This trigger point usually doesn’t disturb sleep but is often involved along with other rotator cuff muscles that do. When the tendons are particularly aggravated, there is tenderness at the top, outside edge of the shoulder.
People may also complain of clicking in the shoulder. Some can reproduce it easily, especially the people who like popping their joints. This is not a “healthy” pop and you should get it fixed so that it doesn’t pop.
This muscle is injured by pulling down on the shoulder abruptly or chronically. You can see how jerking the arm down would cause the end of this muscle to be overstretched, making it less able to stabilize the humeral head. This may occur by carrying heavy things that have a handle like suitcases or buckets. I had an older client come in this week who created this by carrying heavy cabinets to refinish her kitchen. Another common cause is a dog that jerks on the leash. I am surprised at how many dog owners have come back repeatedly with this injury. I had this injury occur when a bracket broke on a porch swing and hit me in the shoulder. Shoulder injuries from blunt trauma, however, are usually from sports and more often involve the deltoid.
Be careful with self-care strategies on this one. Many people want to stretch this when it is already over-stretched by the original injury. Some gentle stretching like the one in this picture, especially under a hot shower, is a common recommendation and should be done gently, if at all. Icing broadly around the top of the shoulder helps to heal the injury and reduce inflammation. There are a number of ice packs made specifically for shoulder injuries like this one.
This can just get worse if you continue to re-injure it or don’t address it once it is bothering you on a regular basis. This shoulder needs to be stabilized before being stretched. This can be the beginning of a chronic rotator cuff problem but usually responds quickly to the right bodywork. See your trigger point specialist for lasting relief.
This pain pattern comes from supraspinatus, a rotator cuff muscle that straps across the top of the scapula. It secures the head of the humerus in place while helping to abduct the arm(move it away from the trunk). It is thought of as being more involved in fine-tuning the movement of the arm than as a prime mover of the shoulder.
Mobilizing the glenohumeral joint and acromioclavicular joint seem key. Working the tender areas on either side of the acromion also seems key. If you don’t have a small, strong thumb for getting into these spaces or these tissues are particularly tight, gentle T-bar work is very effective for symptomatic relief once the perpetuating joint concerns are addressed.
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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.