massage, shoulder, human

Why Do My Shoulders, Neck, & Back Hurt?

Common Challenges

  • After nearly a decade as a medical massage therapist and master level in my profession I see often the challenge of anterior rotation of the shoulders (shoulders rolling forward) which causes:
    • Pain or numbness in neck, shoulders, and back
    • Carpal Tunnel Syndrome
    • Arm, hand, finger numbness
    • Tension headaches and migraines in some cases 
Stress = Scar Tissue
  • Sometimes scar tissue can be helpful as with walking barefoot builds callus’s. Other times chronic stress builds scar tissue that leads to limited movement and improper muscle contraction and release. 
  • Chronic forward rotation of the shoulders will lead to tight neck and shoulders. Common results are the formation of trigger points, pain you can pinpoint, which often radiates to another spot. Similar to our vehicles having check engine lights, this is a normal response.  You should take note of what’s happening and correct what is causing it.
  • If left uncorrected this can lead to discomfort such as chronic migraines, pain or numbness down the arms. Heaven forbid we have a sudden change like a fall or even near fall. Sudden motion or imbalances like these can cause  sprains and tears when they could be easily avoided.

Recommendations

  • STOP and take time to assess your own body and how it’s feeling. Identify any abnormal new pains or chronic pains you have been living with.
  • Look in the mirror, assess your own posture, or have a loved one do so. If you have an imbalance from side to side or front to back make the corrections necessary to prevent future problems (Please see below). There are many amazing specialists who are trained and experienced to help at anytime.
monkey, mirror, mirroring

What Can I Do?

  • As a Licensed Massage Therapist and Master Body Worker I can assess your posture in a relaxed position. I can determine with simple Shoulder Flexion and Lateral Shoulder Abduction (see below) any imbalances from side to side. While in the massage session I can test your muscles to determine which muscles are out of balance and are triggering added stress in your neck and shoulders.
  • Surprisingly it isn’t always the same on both sides of your body that are out of balance.  Being able to find where the imbalances are, I can recommend strengthening or stretching exercises that will be the most effective. It’s important to me that you be educated with methods that will help you manage pain and improved quality of life.

Shoulder Flexion Test

Shoulder Abduction Test

Muscles that make up the Rotator Cuff

  • Subscapularis – Is a large triangular muscle which fills the subscapular fossa of the scapula and a muscle of the rotator cuff. This muscle is commonly shortened and full of scar tissue when a person has a profession that causes common use of arms extended in front such as:
      • Computer work
      • Driving
      • Massage Therapists 
      • Chronic phone
      • Reading
      • Gaming
  •  The function of subscapularis is to rotate the shoulder from out to in (medial rotation). It stabilized the shoulder. *See above photo where the nerves and blood vessels come into the shoulder. If subscapularis is too tight it rolls the top of the shoulder forward and pinches off the nerves and blood vessels. Which could cause any of the conditions above.
  • Stretching that can help – Doorway Stretch (see below). 
      • *Tip: Stepping forward with the inside for more forward force and looking away can help stretch the neck along with rotator cuff and pectoral muscles. By adjusting elbow higher and lower than the shoulder joint can allow for different pectoral (chest) stretches. 
  • Supraspinatus – As the name implies this muscle is above the spine of the scapula. The supraspinatus assists the deltoid (big shoulder muscles) in abducting the arm and stabilizes the shoulder joint.
    • Strengthening exercise that can help – Front Lateral Raises (see below)
  • Infraspinatus – This is a thick, triangular muscle in the shoulder on the posterior (back) side. This muscle is important for shoulder stabilization and to maintain proper movement of the upper limb. Along with the Teres minor, this muscle laterally rotates and performs the horizontal abduction of the arm. It also assists the deltoid muscles (shoulder muscles) with abduction.
    • Strengthening Exercise to help – External Rotation Standing with cable, External Rotation lying with a light weight (see below)
  • Teres Minor – Is a narrow, elongated muscle of the rotator cuff, along with the other muscles of this group it stabilizes the shoulder joint and maintains proper movement of the upper limbs. The function of this muscle is the lateral rotation and horizontal abduction of the arm at the shoulder joint.
    • Strengthening exercises that will help – External Rotation seated with weight, or with a cable (see below)

Apps Referenced – 

  • Muscle 2020 VisibleBody 
  • 3D medical – iMuscle 2

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