When the pain in the front of your shoulder is caused by the back of your shoulder
A lot of people present to the clinic with pain in the front or side of the shoulder. Rubbing the front of the shoulder and stretching the chest hasn't helped. You may have even seen a physio that has diagnosed a shoulder impingement and given you some exercises that seem to make it feel worse. The doctor wants to do a scan and maybe an injection and pump you full of antiinflammatories. But one thing you and they have overlooked is the trigger points in the infraspinatus muscle in the back of the shoulder. This is one of the major rotator cuff muscles that helps to stabilise the shoulder though all movements.
The trigger point when active and inflamed can radiate pain from the back of the shoulder to the front. If you have a look at the picture above, the X's are the trigger points and the red area is the radiating pattern. So if you were to place a massage ball into those X's and press reasonably hard you may feel some pain radiating in those patterns.
So the challenge for you is now to dig out your trigger ball and get rolling around on it. You can do this up against a wall or on the floor.
How long should I roll on it?
Generally the consensus is to hold static pressure for at least 30 seconds while you feel it radiating. You can then have a break and repeat multiple times. Over time it should diminish and stop radiating pain. It will likely always be a bit painful in the back of the shoulder as it is one of the most worked muscles in the shoulder and one of the most painful in the body.
Other ways to treat it.
At Muscle Therapy Australia we use trigger point therapy as one of the pillars of our treatments and one of the most effective trigger point techniques is Dry Needling. Dry Needling gets to the heart of the trigger point and stimulates it to release. It also attracts the body's immune system to start sending vital nutrients to the area to heal it.
What if it's weak?
If the infraspinauts is weak then you guessed it. We need to strengthen. Simple isolated external rotation exercises are the first port of call as we need to get some intrinsic strength into it. Then we can work on stabilising exercises that use the infraspinatus in different planes of motion.
Check out thesis videos on what to do.
So there you have it. If you have pain in the front of your shoulder you should be looking at the back. Get in touch for an assessment and treatment and get you out of pain.
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