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Posted on 12-17-2015
Author Dr. Ryan Curda D.C.
Do you wake up in the middle of the night with shoulder pain? Is there a constant dull ache that doesn’t seem to be caused by any one thing? You’re not alone. Shoulder pain can be caused by a wide range of causes; from a sports injury, collision, referral pain, brachial plexus irritation, instability, or most commonly an impingement syndrome developed over time. When dealing with a shoulder impingement it is important to understand what is happening within the shoulder to properly treat it. Shoulder impingements most commonly develop from chronic internal rotation of the Humerus, which is the long bone in your arm. Internal rotation occurs due to an imbalance of the muscles attached to it. We have four large muscles that contribute to internal rotation of the arm and only two smaller muscles that contribute to external rotation. If the Pectoralis Major, Lattisimus, Sub-scapularus, and Teres Major (internal rotators) do not have proper engagement of the Infraspinatus and Teres minor (external rotators) during shoulder movement then the joint becomes imbalanced and chronically in a position of internal rotation.
So what’s so bad about internal rotation? Well, there are several structures that pass under the scapula and over the head of the Humerus; the long head of the biceps tendon, supraspinatus tendon, and the sub-acromial bursa. Internal rotation decreases the space for these structures to pass, which in turn causes irritation, which causes inflammation and fraying, which leads to pain. That is why if you have an impingement syndrome it will feel worse when you sleep on your shoulder on that side, because you are then compressing an already compressed space.
The good news is that just as your body has been trained to do the wrong things; either from improper neurological firing or years of poor posture. Your body can easily be re-trained to do the right things. Balancing the muscles, re-training the joint motion, and making your body more posturally aware can all be achieved without time consuming physical therapy or painful and costly surgery. The first step is receiving a comprehensive assessment to determine the cause of your shoulder pain. Prolonging care can eventually lead to more difficult conditions like frozen shoulder, or even tendon rupture. Take your health into your hands and contact a Chiropractor in your area today.
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-Dr. Ryan Curda
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