Shoulder pain is, well, a pain.
Sure, there are conditions – rotator cuff tear, labral tear, tendonosis, and others – that can cause shoulder pain and require professional guidance to help resolve.
But, for garden variety shoulder pain or “impingement” (when you feel a sharp pain in the shoulder upon moving the arm up and across the body), the culprit, quite often, isn’t in the shoulder at all.
It’s in the myofascial network on the back side of the shoulder blade and the trunk.
Specifically, the infrapsinatus and latissimus muscles.
What creates the pain in the shoulder is something known as trigger points in the muscles.
Trigger points are small sections of muscle fiber that are unable to relax; they stay contracted. What causes this? Well, a number of variables can kick off a trigger point but think of a trigger point like a stress fracture in bone.
A stress fracture in bone occurs from overuse of the area or some type of trauma or, vitamin / nutrient deficiency (protein for one). A trigger point can occur from the same things.
As a result, these muscle fibers are very sensitive to pressure and can actually refer pain to other areas of the body. And because the muscles may have more than one trigger point, the overall function will be impaired which can then lead to changes on how your shoulder moves and that can cause pain as well.
The good news is that you can self-manage trigger points, at least many of them, with simple tools: foam roller and a Body Back Buddy (BBB).
You can deactivate a trigger point by applying pressure directly on it. The ideal approach, one that I’ve used with success, is to apply pressure to the trigger point slowly up to a painful level and then back off the pressure just a bit. You’ll know you’re on the point when you feel a referred pain or pain in the area of complaint. Hold this level of pressure while slowly moving the tool in a circular pattern until you feel the muscle soften or yield. Then increase the pressure again until it hurts; back off; hold. Repeat until you have to press fairly hard to produce pain.
This process is time consuming especially if you have more than one trigger point, which many people do, and trigger points are notorious for being very stubborn. You may have to treat the areas several days in a row and several times per day (3-4).
The best tool for the technique I described above is the Body Back Buddy. There’s another device similar to this called a Thera-Cane and it also works. I prefer the BBB because it has several types of knobs and angles which makes it easier to get to certain spots.
To learn how to use the BBB, go here.
The second option is to use a foam roller. With this technique, you won’t be able to apply a graded pressure as with the BBB but you will hit several trigger points at once.
Here’s an example of using the foam roller for the latissimus dorsi muscle and muscles of the posterior shoulder.
Trigger points are a very common source of shoulder pain and can be easily self-managed with relatively inexpensive tools using pressure. If however your pain doesn’t subside after a few days of self-care, get professional help.