Shoulder Pain Site Vs Shoulder Pain Cause
Now that we know a little about the anatomy of the shoulder (click here to see shoulder joint post). Plus we know a little more about structures in the shoulder that can cause shoulder pain (click to see shoulder injury posts).
Now it is time to start putting the pieces together.
One of the common misconceptions that I come across in the clinic in regards to shoulder impingement pain is the concept that “this is where I feel the pain, this must be the problem”.
This introduces the concept of Shoulder Pain Site Vs Shoulder Pain Cause.
Pain Site refers to the structure that has become irritated to cause the pain, e.g. bursa, tendon or ligament.
Pain Cause refers to why has that structure become irritated, e.g. a tight posterior Deltoids may not be letting the arm bone rotate precisely within the shoulder joint and thus impinging the Supraspinatus muscle.
The Supraspinatus tendon may be the site of the pain but it is the tight deltoids that is the cause of the problem.
This may be a subtle but important difference. If we just focus on the pain site, we will be able to reduce the pain and inflammation but we haven’t addressed the root cause, thus there is a very high likelihood that the shoulder pain will return sometime in the future.
To illustrate this more clearly let’s think about the car analogy used in other posts.
Imagine your wheels are out of alignment (this would be the pain cause). As you drive this is going to cause uneven wear and tear on your tires.
At some point down the road it will become necessary to replace your tires due to the abnormal wear (this is the pain site).
Now if you just replace the tires and continue driving you are very likely to have the same problem again and again.
In order to correct the problem properly you not only need a new set of tires but you also need to get a wheel alignment to spread the wear more evenly over the entire tire (treating the pain cause).
That is why when it comes to shoulder pain, for best results it is important to address both the pain site and the pain cause.
