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Writer's pictureRebecca Root

The Reason Why Your Shoulder Is Not Getting Better

Do you have shoulder pain? Maybe it's a pain that has persisted for a long time, or a pain that's been stubborn and comes back as soon as you try to get back to sport from resting it for weeks? To understand how to properly rehab a shoulder or come back from injury, we first have to understand how a healthy shoulder works..

A Healthy Shoulder

The shoulder is a complex joint, it's built to be incredibly mobile - in fact the only bony connection between your shoulder and the rest of your body is via the collar bone! But increased mobility comes at the compromise of stability. Your shoulder joint relies upon a fine balance of tension and action of muscles, tendons, ligaments to keep the shoulder stable during the movements we make with our arm. The main muscles that control movement at the shoulder are known as the rotator cuff.

So how does injury strike?

Now this system works great when every member of the muscle team is doing their job properly, but what happen's when one guy starts slacking? Maybe some muscles have become tight and shortened because we, for example, spend the whole day sitting at the desk slouched over with our arms in front of us at the computer? Or perhaps you totally love doing bicep curls at the gym every week but regularly talk yourself out of lat pull downs or reverse flys (!!)

Activities that can introduce or exacerbate muscle imbalance can be found in pretty much every repetitive activity we do! Well in these situations, every other muscle that controls the joint has to adapt and compensate to keep your shoulder working in exactly the same way.. You take one guy out, and all the others have to chip in a little bit more. This often happens over time without us having any idea and it causes no problems, but there comes a stage when a muscle that has been working extra hard to compensate just can't take the load anymore, it's been working much harder than it was designed to and finally gives up! I'm sure theres some sort of working overtime and quiting a job analogy in there somehow. Well this is exactly how an injury comes about in the shoulder - rotator cuff tear, tendonitis etc

Overcoming injury

Recovering from a shoulder injury doesn't therefore just mean looking at one muscle in isolation i.e. rubbing the bit that hurts. If you don't identify why that muscle has been overworking in the first place, then it'll just come straight back.. this is where a good therapist comes in. Your manual therapist should be able to identify what pattern of structural imbalance has lead to one guy taking all the load.

But maybe we should look further afield than the shoulder? An osteopath won't just look at the shoulder joint, they'll also look at how your neck, mid back, lower back, wrist etc are all functioning. Why? Because the rest of the body works like the shoulder, if you change one thing then the rest has to compensate or adapt. Example? Think about a downward facing dog yoga position - if we shift your hips ever so slightly to the left, just the hips.. feel how the weight through your left arm and shoulder has hugely increased? Imagine doing that repetitively for an hour 2 or 3 times a week for years.. it's no surprise that the shoulder would end up in pain!

Ok let's try another one, lets say you like to play golf - maybe your lower back and hips aren't as good at twisting to the right as they are to the left, now when you rotate back to begin your swing, your shoulder has to move back alot further to make sure you can still achieve the

same movement.. actually making the muscles of the shoulder work that little bit harder than they should with every swing. Failure to look at the bigger picture unfortunately means you can be plagued by the same age old injury for years.

So what's the lesson here? Get aches and pains addressed sooner rather than later, don't wait for all those compensations to build up over time. Maybe that initial pain will disappear because the shoulder has found a way to adapt.. but this may be at the cost of another injury further down the line! Catching these things early may mean that all you need is a slight adjustment in how you perform a particular movement or activity repetitively.. or maybe a little strengthening is needed to get things back to normal. Get your pain or injury diagnosed and treated - book your appointment online now!


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