The solution to fix your shoulder pain will be individual to you and will change from person to person.
However here are the most common problems I see and the common solutions to these problems:
Problem - Thoracic kyphosis / lack of ability to be able to get into thoracic extension
When there is restriction in thoracic extension this will cause compensation at the shoulder blades and glenohumeral joint, this compensation often putting excess force in various structures in the shoulder and causing inflammation / pain.
Solution - Create thoracic mobility and then tie this into movement
Problem - Weak / inactive rotator cuff muscles
A properly functioning rotator cuff should maintain an optimal relationship between the head of your humorous (upper arm bone) and the glenoid (shoulder socket). When this is not optimal various structures can get beaten up causing inflammation and pain.
Solution - Find the weaknesses, strengthen them, tie this activation into movement
Problem - Lack of upward rotation in shoulder blade
If our shoulder blade does not upwardly rotate efficiently / has restriction, this will cause compensation and put excess force on various structures in the glenohumeral joint, causing pain and inflammation.
Solution - Lengthen levator scapulae and pec minor, strengthen lower traps and serratus anterior
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Problem - General weakness and lack of muscle mass in the shoulder supporting musculature
When there in a lack of muscle mass and general strength in our upper body this can make it a real challenge to sustain posture and stability through general movement which ultimately can result in certain structures and connective tissues dealing with amounts of stress that they simply can not handle.
Solution - Have a specific program focussed on building muscle in your weak areas, eat in a calorie surplus
Problem - Pathological issues such as (thoracic outlet syndrome, bursitis, bicep tendonitis, rotator cuff pathologies, muscle strains, muscle spasm)
Pathological issues such as the ones above are a little more complicated and require very specific action which will be dependent on the individual. Its essential that treatment also addresses the reason why the pathological issue happened in the first place (otherwise its just a bandaid - like pain killer drugs) and will not fix the issue long term.
Solution - Allowing recovery / regeneration, alleviating the cause of the issue, Deeper level corrective rehab
Problem - Chronic chest breathing, over-active / stiff neck & upper back
Chest breathing recruits secondary breathing muscles such as our scalenes, levator scapulae, pectoralis minor & sternocleidomastoid. Overactivity within these muscles can result in stiffness and soreness in your neck and shoulders, this can quite often result in the elevation of your first rib which can irritate the brachial nerve plexus causing nerve related pain and symptoms down your arm.
Solution - Learn and practice diaphragmatic breathing, learn to relax the overactive muscles, self massage
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Problem - Tightness / restriction in ankles, hips, thoracic spine or shoulder creating compensation
When the foundational areas of movement within the body are not functioning properly, other areas of the body get more force placed on them than they should - the shoulder can be one of these areas.
Solution - Improve mobility deficits and tie these into movement
Problem - Poor postural & movement awareness in upper body
When we lack quality posture and don't know how to move our bodies optimally many issues can arise. We should have awareness throughout our body and practice correct movement / technique regularly.
Solution - Learn to hold yourself well, move well & learn correct technique
Problem - High stress plus the associated fatigue & inability to hold good posture
When we are in a state of too much stress for too long our bodies ability to recover and function optimally becomes significantly reduced, too much stress negatively impacts the body in so many ways.
Solution - Implement better stress management strategies, look at lifestyle, learn better posture
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Problem - Weakness in the internal rotators (subscapularis) + tight ischaemic posterior capsule
Each muscle in our body has its own unique action, however when it comes to movement no muscle works solely alone. Muscles work as a team and leverage off one another to ideally have each joint throughout our body working in their most efficient state, if there is an imbalance between muscles that should be working together, this can cause problems to arise.
Solution - Strengthen internal rotators, lengthen external rotators, create an optimal relationship
Problem - Depression / mental stress & the poor posture that is a byproduct of this
Being in a state of depression & carrying heavy emotion puts us in a lower that optimal emotional state. When you are in a low emotional state your body language and posture completely change & quite often it can be really hard to find the energy or value in yourself to create the required changes.
Solution - Work on mindset - shift beliefs & perspectives that are keeping you stuck
Problem - Head of humorous bone sitting anterior and superior in the glenoid, reducing the subacromial space
The head of your humorous (upper arm bone) can sit in an sub optimal position in the glenoid (shoulder socket) if certain ligaments are too tight, it may need to be mobilised into the correct position and then strengthened in that position so it stays there.
Solution - Mobilise the joint into its optimal position, activate / strengthen rotator cuff to keep it there