Patients complain of pain in the shoulder when brushing their teeth, combing their hair, putting on make-up, shaving their face, etc. Typically, patients describe this pain as achy and deep in the shoulder. Their primary complaint may also include pain while carrying something by their sides like suitcases or buckets. This trigger point usually doesn’t disturb sleep but is often involved along with other rotator cuff muscles that disturb sleep. Aggravated tendons can create tenderness at the top, outside 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 popping is not a “healthy” pop. It’s a tendon that is twanging over a hard edge. This popping will aggravate and inflame the tendon. So, it would be best if you get it fixed so that it doesn’t pop.
Pulling down on the shoulder abruptly or chronically activates this pain pattern. The tendon of this muscle stops the shoulder from slipping down.
This tendon damage 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 moving 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. A similar injury happens when people jerk weights during resistance training.
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.
The supraspinatus can also get injured by jamming the arm up instead of down. If there is a fall onto the stiff arm, like this woman slipping on the ice, it jerks the arm upward in the socket. Consequently, it overstretches the tendon and aggravates the muscle. Sometimes, it tears the tendon.
As well, these people often end up with fractures in the wrist and elbow. I’ve treated several people in their 40s who decided to give a fresh start at roller skating or shoeing horses.
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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*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 include more patterns with better self-care. Meanwhile, there may be formatting, content presentation, and readability inconsistencies. Until we get older posts updated, please excuse our mess.