Shoulder pain coming from elsewhere in the body: How to find the underlying driver for your problem

A lot of people know that shoulder pain can actually be coming from the neck.
But did you know that changes in the way you stabilise your trunk, pelvis and even your legs could have a massive influence on how hard your shoulders have to work?

How other areas of your body could be causing ongoing issues in your shoulders

A significant proportion of power comes from the lower body when we use our shoulders to throw, lift, push, carry and more.

Therefore if we are returning to these activities after a period of inactivity it is important to ensure there is adequate strength in the lower limbs so that they can assist you in offloading your upper body during these activities.

Another thing we often see is old injuries in your lower body that are causing poor movement patterns in the shoulder and surrounding areas.
For example, if you have a ‘dodgy knee’ or an ankle sprain you didn’t rehab properly, this may mean you are not able to shift your body weight effectively onto that side.

When you are using say your right arm to lift something up onto a shelf – being able to shift your weight is critical for balance and stability. If this is impaired, your shoulder will work much harder to compensate for the lack of weight shift.

Ensuring you have good trunk control (or core stability) is also important as it is responsible for making sure the shoulder is in the right place for the desired task and it is a vital link in the kinetic chain where force is transferred from the legs to the arms. Without a well controlled thorax this can lead to increase load on the shoulder as well.

Why our shoulder exercises sometimes look like ‘core exercises’

For the reasons above, in the late stage of shoulder rehabilitation the exercises we choose can look very similar to core stability exercises.

We will often challenge the shoulder in more weight bearing type tasks which challenge the control and proprioception (joint position awareness) of the shoulder.

An example of this would be like in the picture below where I am putting my body weight through my arms and challenging my core and shoulder muscles to work together in an efficient way.

Strength training for shoulder pain

 The thorax (trunk) can also act to be very protective of the shoulder. When we have pain for a long time, we will often stabilise the shoulder excessively by “gripping” it onto you torso or holding it close to your body.

This can make your upper back, ribcage and neck feel stiff.

If you have reduced thorax mobility, particularly rotation, this will also lead to increase load on the shoulder as the shoulder is required to work harder and in positions it cannot control as easily.
Our physiotherapists will often target the thorax to increase mobility and remove this excessive strain on the shoulder girdle.

To find the underlying contributors of shoulder dysfunction, our ConnectTherapy and Thoracic Ring Approach to shoulder assessment is the best choice. Find out more by heading to the link below!

Learn about ConnectTherapy for Shoulder Pain

Written by Declan Price

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