Shoulder Pain & Treatment
Shoulder pain is common, especially in athletes and people with active jobs.
You use your shoulders all the time, so when they aren’t working right, it can be a challenge.
To put it simply: shoulder pain is inconvenient at best, and debilitating at worst.
We offer mobile chiropractic treatment for shoulder pain in
Delano, Maple Plain, and the rest of Wright and West Hennepin Counties.
Below we discuss some common causes of shoulder pain:
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Rotator Cuff Injury
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Frozen Shoulder (Adhesive Capsulitis)
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Impingement Syndrome
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Shoulder Instability
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AC Joint Pain
Rotator Cuff Injury
The rotator cuff often comes up when talking about shoulders. It’s made up of four muscles: Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis. These muscles work to move your shoulder around, but they also stabilize your shoulder and keep it from popping out of its socket.
Specific rotator cuff problems vary based on your age and your activities, but typically they include tendinopathy (degeneration of the tendon), partial tendon tears, and complete tendon tears. In older adults, these are usually slow tears that happen with overuse and general life activities, while younger adults typically experience tears after a trauma or specific injury.
Around 30% of people have rotator cuff injuries by age 60, but it’s important to note that not all rotator cuff injuries cause pain or dysfunction. Seeing degeneration or tearing of a rotator cuff tendon on a scan does not automatically mean that is the cause of your shoulder pain or that you definitely need surgery.
Common causes and risk factors for rotator cuff injury include:
Aging
Poor posture
Overhead jobs or hobbies, like construction work
Certain sports, including baseball, volleyball, and tennis
History of rotator cuff problems
Symptoms of rotator cuff injuries usually come on gradually over time, but they can show up quickly after an injury. Symptoms can include:
Dull, deep ache in the shoulder
Difficulty with overhead activities
Problems sleeping on the affected side/shoulder
Limited range of motion of the shoulder
Weakness in the shoulder and/or arm
Rotator cuff injuries can be managed, and they can be avoided.
Dealing with rotator cuff injuries long-term requires reducing the cause or potential cause of the issue while allowing the rotator cuff to heal and rehabilitate.
Treatment for rotator cuff injuries may include:
Chiropractic Adjusting - Adjustments of the neck, midback, and shoulder can help to improve the range of motion in the shoulder, reduce pain, and increase motor control.
Soft Tissue Mobilization - Assisted stretching techniques, manual therapy, and trigger point work can help loosen tight muscles, reduce pain, and increase mobility. When certain muscles are tight, they can increase strain on other muscles in the rotator cuff, increasing the risk of injury.
Corrective Exercise - Specific stretches and exercises are used to strengthen weak muscles in the rotator cuff to ensure balance and minimize the risk of injury. After an injury occurs, exercises are necessary to encourage proper healing and health, while strengthening the rotator cuff muscles to prevent further injury.
Lifestyle Changes - Depending on your occupation and daily routine, certain changes may be necessary to reduce strain on the shoulder for a while. This could include changing how you work or play, getting a better workstation setup, or improving your posture.
Frozen Shoulder
Frozen Shoulder, also known as Adhesive Capsulitis, is a common condition affecting middle-aged adults. It involves a gradual stiffening of the shoulder, followed by an extended period of limited mobility. As a whole, from start to end, frozen shoulder can take 2-3 years or more to play out.
The exact cause of frozen shoulder is unclear, but it appears to be an inflammatory condition or autoimmune process. The process involves inflammation of the shoulder joint, followed by fibrosis (thickening) of and formation of adhesions in the ligaments and joint capsule around the shoulder.
Frozen shoulder is often described as a contracture, meaning that the soft tissues get shorter, tighter, and harder than normal. This severely limits the range of motion in the shoulder, leading to the “frozen” part of the name. These contracted soft tissues also cause problems with activities like getting dressed, reaching overhead, and putting on a seatbelt
Common risk factors of frozen shoulder include:
Diabetes Mellitus, Type 1 or 2
History of shoulder trauma or surgery
History of extended shoulder immobilization/bracing
Autoimmune diseases and seronegative arthritis, like psoriatic arthritis
Thyroid problems
Being female
Symptoms of frozen shoulder usually show up gradually over time. They can include:
Dull or aching pain in the shoulder, often in the front
Increased pain with shoulder movement
Decreased range of motion of the shoulder
Limited ability to reach overhead and behind you
Pain that gets worse at night, or inability to sleep on the affected side/shoulder
Symptoms gradually get worse and worse
Neck pain associated with compensating for the limited range of motion
Frozen shoulder can be a huge challenge, but there are ways to help.
Dealing with frozen shoulder can be difficult, as time is often the only thing that can get you back to where you were. But don’t lose hope, as conservative treatments can provide relief and limit the symptoms and problems you’re dealing with on a daily basis.
Treatment for frozen shoulder may include:
Chiropractic Adjusting - Gentle adjustments and mobilizations of the shoulder can help to slowly improve your range of motion, or at least limit the loss of mobility. Adjustments can also relieve pain in the neck and midback, which often compensate for a loss of motion in the shoulder.
Soft Tissue Mobilization - Assisted stretching techniques, manual therapy, and trigger point work can help loosen tight muscles, reduce pain, and increase mobility.
Corrective Exercise - Specific stretches and exercises are used to help release the contracted soft tissues on a regular basis. This regular activity is essential for you to have the best chance of improving.
Nutrition & Lifestyle - Frozen shoulder appears to be an inflammatory condition, so addressing inflammatory factors in your diet and lifestyle can be helpful. Modifying your diet to include less processed foods and sugars, reducing stress, and promoting good sleep are all things that can help reduce inflammation in the body.
Impingement Syndrome
Impingement syndrome, also called subacromial impingement syndrome, occurs when your humerus (the bone in your upper arm) rides up in your shoulder socket and squishes the tendons above it into part of your shoulder blade called your acromion.
This area between the humerus and the acromion is called the subacromial space (hence subacromial impingement syndrome) and contains a number of structures, most notably the tendons of two rotator cuff muscles and the tendon of the long head of your biceps. All of these muscles and tendons are critical to the movement of your shoulder.
When you raise your arm, the humerus normally does something called “centration,” meaning that it stays in roughly the same spot in the shoulder socket as it usually is. Sometimes, the muscles that do this centration stop working well or don’t contract at the right time, allowing the humerus to ride up in its socket and smash into the acromion, squishing all those tendons between.
Over time, this squishing can lead to inflammation, degeneration of the tendons, rotator cuff injuries, and even tears or ruptures of the tendons. Luckily, you can address your shoulder impingement before those bad things happen, and even if it’s progressed, you have options.
Common causes of Impingement Syndrome are:
Normal anatomical variations of the acromion (curved or hooked shapes)
Repetitive overhead activities, such as volleyball or construction work
Weakness or imbalance in your rotator cuff or other shoulder muscles
Trauma to the shoulder
Symptoms of Impingement Syndrome include:
Pain when moving your arms overhead
Pain and tenderness in the front of your shoulder and/or the side of your arm
Pain when lying on the affected side
Shoulder and/or arm weakness and stiffness
Sensations of catching or sticking in the shoulder
Impingement Syndrome can be managed with the right care.
Impingement Syndrome can be a complex issue to manage, but it can be done with the right approach. The hard part about Impingement Syndrome is that there is no “one cause,” as every patient may have different issues contributing to the impingement.
Some may have rotator cuff imbalances, while others have weakness of the trapezius, and others may have nerve issues leading to muscular imbalances. It takes the right examination and history to effectively diagnose and treat your shoulder impingement.
Treatment for Impingement Syndrome may include:
Chiropractic Adjusting - Gentle adjustments to the shoulder, neck, and midback can help correct biomechanical issues that are impacting the shoulder’s ability to move correctly. Adjustments also decrease pain while increasing control and coordination of your muscles.
Soft Tissue Mobilization - Assisted stretching techniques, manual therapy, and trigger point work can help loosen tight muscles, reduce pain, and increase mobility. Treating the right muscles can help your humerus move correctly to stay centered in its socket.
Corrective Exercise - Specific stretches and exercises are used to strengthen weak muscles and relax tight ones. Each patient can have a different pattern of weakness and tightness, so each patient needs an individualized exercise and treatment plan.
Shoulder Instability
Your shoulder is one of the most mobile joints in your body. It’s officially called a “ball-and-socket joint,” similar to your hip. However, the shoulder is in a much shallower socket, allowing it to move around more but also providing less stability than the hip. Most of the shoulder's stability is provided by the muscles and ligaments around it, making it more susceptible to instability than most other joints, which often have bones that help to hold things together in addition to the more flexible and vulnerable muscles and ligaments.
Shoulder instability often occurs after trauma, including sports injuries, dislocations, and surgeries. These can stretch or damage the ligaments that provide stability, while also weakening the muscles in and around the shoulder that support it and keep things in place as well. Other biomechanical changes, including a lack of motion in the neck or midback, can cause the shoulder to compensate as well, increasing the risk of instability in the shoulder joint.
Causes and risk factors of Shoulder Instability include:
Previous dislocation or shoulder trauma/injury
Generalized hypermobility, double-jointedness, or Ehlers-Danlos Syndrome
Imbalances in the shoulder and scapular muscles
Participating in contact sports like football and hockey
Symptoms of Shoulder Instability include:
Feeling of looseness or slipping in the shoulder
Repeated dislocations of the shoulder
Pain in the shoulder, especially with movement
Changes in range of motion of the affected shoulder
Shoulder Instability is manageable.
The major goal when addressing shoulder instability is to get the muscles around the shoulder working at their fullest capacity. While we often can’t make ligaments tighter, muscles can easily be strengthened to provide extra support.
Addressing shoulder instability requires an approach that addresses multiple factors, including the joints, the muscles, and the soft tissues. This can include:
Chiropractic Adjusting - Gentle adjustments and mobilizations of the shoulder can free up any adhesions or limitations in your range of motion, which can change the biomechanics of your shoulder and cause instability. Adjustments of the neck and midback can also help manage shoulder instability, as the shoulder is connected to both the neck and midback and will compensate for a decrease in motion in either of those areas.
Soft Tissue Mobilization - Assisted stretching techniques, manual therapy, and trigger point work can help loosen tight muscles, reduce pain, and promote proper biomechanical movements. Often, the muscles in the front of our shoulders are tight, changing how our shoulder works. Additionally, most shoulder instability occurs when the shoulder moves towards the front, so loosening the muscles pulling in this direction can help significantly.
Corrective Exercise - Specific stretches and exercises are used to help strengthen your shoulder and scapular muscles to increase stability. Often, especially after an injury or surgery, our shoulder muscles get weak and can no longer manage the work we need them to do; if these muscles aren’t working well or are too weak, the shoulder can slide around too much in its joint, creating instability.
AC Joint Pain, Injury, & Separation
The AC joint is related to 40% of shoulder injuries and nearly 10% of overall injuries in contact sports.
The AC Joint (acromioclavicular joint) exists right at the “point” of your shoulder, at the end of your collarbone (clavicle). This joint is involved in controlling the movement of your shoulder blade and serves as the only joint directly attaching your shoulder blade and arm to your body. The AC Joint is an essential part of creating the full range of motion of your arm, allowing it to move overhead easily and without much thought.
The AC Joint is relatively small and in a vulnerable location, making it prone to injury, particularly in physical sports like football or hockey. These injuries most commonly include AC joint sprains and tears (separated shoulder injuries), but can also include arthritis, fracture, and overuse injuries.
Causes and risk factors for AC Joint injuries include:
Landing on an outstretched arm or directly on the shoulder
Getting hit in contact sports, especially hockey, rugby, and football
Falls, especially during activities like riding a bike
Car or motor vehicle accident
Overuse of the shoulder
Excess overhead activity or lifting
Symptoms of an AC Joint injury or separated shoulder include:
Shoulder pain
Swelling, bruising, or deformity in the shoulder
Pain with moving the arm to the side and overhead
Pain that travels from the shoulder to the neck or back
Difficulty sleeping on the affected side
How We Take Care Of AC Joint Injuries
With any condition we see, we take the time to develop a care plan specifically for you and your needs.
For AC Joint Problems, this might include:
Chiropractic Adjusting - Gentle adjustments in the neck and midback can relieve pain that might be traveling from the shoulder. Additionally, many AC joint injuries require the shoulder to be held relatively still, and the neck and midback often develop pain from supporting the weight of the shoulder and compensating for the reduced range of motion.
Soft Tissue Mobilization - Assisted stretching techniques, manual therapy, and trigger point work can also help loosen up tight muscles, reducing pain in the neck, midback, and shoulder.
Corrective Exercise - Once the joint begins healing, specific stretches & exercises are used to strengthen weak muscles to support the shoulder while also relaxing tight and painful muscles in the neck and midback.
Lifestyle Changes - Depending on your occupation and daily routine, certain changes may be necessary. These could include avoiding overhead activities and taking a break from contact sports while the shoulder heals.
At Northbound Chiropractic, we work with you to find the cause of your shoulder pain and create an individualized treatment plan targeting your specific problems.
We’ll make a plan with you to get lasting results, so you can continue doing the things you love.