People complain of a couple of different things.
Active people complain of pain on the top of their shoulder when lifting their arm. When I ask them to lift their arm, it doesn’t really hurt until their elbow gets level with their shoulder and the tip of the shoulder begins to rotate upward. This is the point that the middle trapezius strongly engages. Sometimes they will produce the pain by wiggling around their shoulder until they lift it up and back. They also complain of pain during exercises that lift their arm above their head as that also rotates the scapula upward.
This extended side pose from YogaBasics is a good example of that movement. It lifts the elbow above the head while opening the chest by retracting the scapula.
People who carry something with a strap over the shoulder have tenderness on that spot where the bag presses into the shoulder. They will shift their purse, baby bag, travel bag or yoga bag to the other shoulder and smile as they tell me that the bag is probably causing the problem. This combination doubly aggravates this spot as it presses into the trigger point while the trapezius is rotating the shoulder up to keep the bag in place. People with a backpack may carry it by the strap or just put it on the other shoulder.
People may also complain of a heavy coat that rides their sore shoulder, leaving them irritated. Children with sensory processing disorders may complain that they “just don’t like” their coat or backpack.
Obviously, stop carrying that bag on that shoulder until you get this fixed. But like my post on Cute Shoes, and my post on The Investors, I think we should get our bodies working better to improve the quality of our life instead of continuing to age by limiting our choices.
You can reduce the inflammation here with an ice pack, but the latent trigger point will not go away until this is area is worked, the tendons are released, and the acromioclavicular joint is balanced.
This area responds well to direct work after taking care of cervical fixations and distracting the acromioclavicular joint. This is one of the few areas where I use a T-bar on a trigger point. The tendon of supraspinatus and biceps brachii are almost always in need of some direct work for lasting results. People don’t usually complain about this until other muscles have become involved.
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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.