Your Pain Pattern,
What Aggravates It,
The Underlying Anatomy
How to Get Relief,
How People Describe This Pain Pattern
People complain of pain that disturbs their sleep when lying on the painful shoulder or on the opposite shoulder. It is a deeper pain than the illustration suggests. They have spent most of their time sleeping on that shoulder with that hand in front of them. It usually comes on gradually over months and eventually gets difficult to ignore.
Often, the afflicted has tried many sleeping positions and would just like to get back to sleeping on their side, which is most restful.
There are other symptoms that are common but not always present, The grip is weak on that hand and they have learned to be careful with things like a coffee cup. They may have pain in the back of the neck but usually don’t complain about that, at first. They may also have pain when reaching high overhead.
How You Activate and Intensify This Pain Pattern
Tucking in a shirt or reaching to the back seat is painful and aggravates the trigger point. It can be sharp when you extend their arm out to put something on the nightstand.
This pain pattern may come on quickly when there is a trauma to the shoulder. Common incidents include when the shoulder gets twisted against the front of the body in a fall. The shoulder may also get overstretched by a dog that jerks the shoulder forward on a leash.
If the trigger point is already mildly aggravated and the shoulder joint is binding, it can be intensified by reaching back suddenly or having the arm forced back. This can also happen when catching yourself in a fall or reaching back quickly to attend to a child in the car.
The trigger point is activated at night because sleeping on that shoulder has chronically pushed the humerus in the shoulder socket and the muscle has tightened to stabilize the shoulder. Just a trigger point doing its job.
Testing to Assess the Trigger Point
These tests will produce pain and restricted motion when the trigger points in the infraspinatus are active.
The first test involves placing the forearm across the low back. It usually produces pain in the shoulder. Pain worsens as you reach up the middle of the back. Notably, this may also indicate trigger points in the coracobrachialis with a different pain pattern.
In the second test, reach around the back of your head like the pic. When the trigger points are active, it is restricted and painful. Also, you cannot contact the edge of your mouth without pain and stiffness.
The Musculoskeletal Anatomy Behind Your Pain
Getting Relief on Your Own
This post has strategies for getting relief on your own. Explore how to change your activities, stretch, and other strategies that relieve the pain associated with this trigger point.
Treatment Notes for Massage and Bodywork
Through Shared Expertise.
This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.
This site is undergoing changes. Starting in early 2020, we began improving the format. We are also adding more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We appreciate your input and feedback. You will see us adding posts and updating older posts as time permits.
Weekly Featured Post
This post shows you how to press out the trigger points and stretch the infraspinatus muscle. It’s a small muscle on the back of the shoulder but creates a number of problems, including:
- shoulder pain when sleeping
- loss of grip strength
- upper neck pain
- pain along the inside edge of the shoulder blade
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.
*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read. The result will also be more accessible and
will include more patterns with better self-care. In the meanwhile, there may be inconsistency in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.