By John Giametta
Shoulder pain is a common condition that can be quite debilitating. There are various pathologies that can lead to shoulder pain; however, where the pain is located might not always be where the real problem or solution is found.
Our bodies have been designed in a way so that some of our joints are meant to be mobile, while others are meant to be stable. If we take a glimpse at our shoulder complex, shoulder joint, or glenohumeral joint, it is meant to be mobile, and our shoulder blade or scapula is meant to be stable. If we look outside the shoulder complex, but in close proximity, our upper back or thoracic spine is also an area which is meant to be mobile. It is common for a bit of a role reversal to occur between the shoulder blade and upper back, which can alter body mechanics, causing increased stress at the shoulder joint, and eventually leading to pain.
Our world today revolves around technology, such as smartphones, tablets and laptops, which can make it seem like maintaining good posture is nearly impossible. When we fall into these bad postural habits, muscles that are meant to keep your shoulder blade stable become weak. Our upper back can become stiff, leading to this stable/mobile role reversal. There is benefit to treating the pain directly with a combination of manual therapy and exercise at the shoulder joint specifically. However, if you really want to get to the root of the problem, you may want to look outside of the shoulder joint. Recent studies have shown that patients with shoulder pain can demonstrate an immediate reduction in symptoms and improvement in function following manual therapy focused on restoring mobility to the upper back. Following up these manual therapy techniques with exercise that emphasize stability at the shoulder blade and maintaining mobility through the upper back are likely the best solutions to keeping shoulder pain at bay for the long term.