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 motion that strongly engages the middle trapezius. 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, which also rotates the scapula upward.
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.
A few different motions aggravate this.
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.
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This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.
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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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