How People Describe This Pain Pattern
A patient will hold their arm up as if they have it on top of the steering wheel. They trace along the outside of their shoulder and say, “It hurts right here, and sometimes in my forearm.” As well, the pain can shift and bother them worse in the forearm.
When I ask them if there is a motion that they can use to reproduce it, they crook the elbow slightly, hold their arm up at shoulder level and turn it like they are steering a car. They often remark that it bothers them when they hold their arm on the steering wheel for an extended period or when they cross mid-line. Once it gets acutely aggravated, they have trouble getting comfortable.
This is an interesting pattern as I usually only see a few cases a year but have seen a lot of it this year (2016). Research also speaks of it as a less frequent pattern, so why are there so many more cases in my practice now?
How You Activate and Intensify This Pain Pattern
The pain in the shoulder and forearm bothers people more when they pull across mid-line. Steering a car with a stiff steering wheel requires constant fine-tuning for turns and curves.
One client irritated this with a simple day of re-potting plants. The simple motion of repeatedly picking up moderately heavy pots activated this. It didn’t bother her until the next day but got worse over weeks.
This pain in the shoulder or forearm is irritated by several sports activities. The cross-motion of the overhand serve in tennis bothers them, particularly if they extend the shoulder fully. As well, some weightlifters also complain of this when doing lat pull-downs or shoulder presses. Pull-overs can aggravate this if they are jerky or the shoulder is not warmed up. (They can really help as well – see the self-care section)
Also, people complain of this when they sleep on that shoulder with the arm extended so that the elbow is above their head.
The Musculoskeletal Anatomy Behind Your Pain
Very Similar Pain Pattern, Different Muscle
The pain pattern in this other post can feel very similar. The motions that irritate them are different. Often, they are both in need of care.
Getting Relief on Your Own
This post has strategies for getting relief on your own. Explore how to change your activities, stretching, 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.
Support Integrative Works to
and produce great content.
You can subscribe to our community on Patreon. You will get links to free content and access to exclusive content not seen on this site. In addition, we will be posting anatomy illustrations, treatment notes, and sections from our manuals not found on this site. Thank you so much for being so supportive.
The Integrative Model
We want your feedback! We are in the process of creating a format for individual muscles.
Please drop us a note at
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.
Question? Comment? Typo?
*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.