If I had a dollar for every time I heard, ‘Why does my shoulder pinch every time I lift my arm overhead?’
I’d live in a 4 story mansion in Vaucluse, with a Lamborghini, Ferrari and Porsche in the garage. Well not quite, but you catch my drift.
Most of us have either experienced or heard someone complain about this type of pain in the shoulder. It’s one of the most common questions I hear in clinic.
Often followed by a series of pressing queries…
Am I lifting too much weight?
Is my form wrong?
Should I stop lifting all together?
Is this what Armageddon feels like?
Alright, just calm down for a second or two.
Without keeping this blog too dry, let’s have a quick look at what the shoulder joints are made up of
The Shoulder Joint Simple, Systematic and Sweet
The shoulder is made of 3 main joints:
Scapulothoracic
Shows how well and smooth the connection is between the shoulder blade and the back of the ribs
(yes your ribs are not just at the front but in fact start at the spine – hence the word ‘ribcage’.)
AC (acromioclavicular) Joint
Is the connection between the collarbone and the front of the shoulder blade
Glenohumeral Joint
The connection between your arm and the shoulder blade
Have you noticed a common theme in the shoulder? If you read the table you’d pick it… Do you think the shoulder blade is important with any sort of shoulder problem? I bet you’re saying, alright baldy, I’ve heard enough on the anatomy lesson…
The Shoulder Blade Is Key
But How Do I Fix My Bloody Pinching?
This is where I get to have some fun playing detective. Need to figure out the ‘why’
Usually when people complain of pinching going overhead at the tip of the shoulder, they point straight to the AC joint.
Why?
Well, what is in the joint… bursa which reduces friction between the tendons of the long head of biceps tendon and the supraspinatus tendon.
Why is that important? If you look at the mechanics of the shoulder, in simple terms
Glide – Slide – Rotate – Compress
When we lift our arm from by our side over our head:
our shoulder blade has to “glide” upward and outward freely over the rib cage.
the humerus head simultaneously “slides” downward while “rotating” upward.
the AC joint (at around 45 degrees +) needs to “compress” itself to allow for the continuation of this movement.
*If it any point the words highlighted are altered in anyway, you will have pinching in the shoulder,
Alright mate, stop with all this medical mumbo jumbo and get to the point.
WHY?
Just kidding, but really I’m not. The “pinching” sensation is the effect and site of pain. This can be treated and you would feel better. But as the spinal neurologist Dr. Karel Lewit said –
“He who treats the site of pain is lost”
The pain will always return unless you treat the WHY?
The pinching pain could be from inflamed structures within the joints or altered mechanics. Generalised rehabilitation of your shoulder doesn’t always work.
It needs to be targeted and specific to YOUR diagnosis and/or dysfunction.
If you don’t believe me, have a look at how many muscles influence the shoulder joint…go on I’ll wait
Even without reading all those crazy names of muscles above, you can appreciate that any one of them overworking or underworking will have an effect on the functioning of the shoulder.
Now that we have looked at the functioning and anatomy of the shoulder how can I tell what is the real cause? You need
A systematic approach to diagnose a disorder or dysfunction of the shoulder
I like to start at the joint closest to the body. The reason for this, is what I like to call
The “cascade” effect
If the joint closest to the trunk of the body is dysfunctional, it would make the rest of the chain also dysfunctional. Hence a wrist or finger issue could be cause by a shoulder blade issue. So….
I start with the shoulder blade, and then make my way to the AC and glenohumeral joints respectfully.
But…How do I fix my shoulder pinching?
Well….
I’m not going to tell you!
I could give you 50 releases and another 50 rehab exercises, but I have no idea if it’s going to help YOUR shoulder.
Everyone is different!
We are all unique in our makeup, character and function. That is why it is so imperative to have a diagnosis of your shoulder issue.
My best advice
Get your niggly shoulder that:
has been pinching for the last 3 months
you thought would get better with time
and hasn’t…
Checked by a medical professional. Make sure they explain what is wrong with YOUR shoulder and how to solve the issue.
Lastly, don’t be afraid to ask them WHY?