Chronic shoulder pain has one common finding. The shoulder that is painful no longer moves efficiently. There is a problem with the shoulder mechanics and movement is abnormal. We call this a shoulder dyskinesia or scapula-humeral dyskinesia.
How you know you have a shoulder dyskinesia
While looking in a mirror raise your arms above your head. Are your hands facing the same way? Is the space between the head and upper arm equal?
Put your arm behind your back and reach up as high as you can. Check both arms. Does one go higher than the other?
When testing for a shoulder dyskinesia it is helpful to have a physical therapist, chiropractor of medical doctor check to see if one shoulder moves differently than the other. There are more tests that can be done to determine where the problem is coming from. Is it a spinal problem or is the ball and socket of the glenohumeral joint affected?
A common condition with a shoulder dyskinesia is an impingement syndrome or pain when you raise your arm. Pain is worse in the mid part of your shoulder motion around shoulder height. Pain can be increased when pulling your arm across your chest.
Over time, a shoulder dyskinesia will start to irritate or ‘pinch’ your rotator cuff. This creates inflammation and swelling and can weaken your rotator cuff causing repetitive injury. It is characterized by pain in the mid part of shoulder motion. Sometimes this is bad enough that a steroid injection is necessary to reduce swelling and pain to allow for a treatment program to be effective. When you have an impingement syndrome exercises are the last thing you should try.
Is your rotator cuff torn?
Clinical testing can help us determine what structures are involved, painful and inflamed, and even injured or torn. A diagnostic ultrasound of the shoulder is incredibly accurate when assessing the rotator cuff and can give further information on how the shoulder moves.
Diagnostic Ultrasound is like getting an MRI of the shoulder!
You can see the tendons and joints.
Diagnostic ultrasound will show if there is a torn rotator cuff as well as arthritic changes, swelling to the tissue, and even if the shoulder is moving normally. It is fast, safe, and gives you and your doctor a better understanding of what is wrong and what next steps need to be taken.
Exercises you can try at home!
With any shoulder problem the goal should be to restore the normal mechanics of the injured shoulder
TIPS
There are many shoulder exercises online and sometimes it is hard to know what is good information and what could be harmful. With any shoulder problem the goal should be to restore the normal mechanics of the injured shoulder first. Start with restoring motion to the stiff joints and address muscle tension and pain. Strengthening should be the last thing you try after you restore normal shoulder motion.
Do not start treatment with shoulder strengthening exercises!
Treat the underlying joint stiffness or loss of motion
Treat the muscle knots and trigger points
Restore normal tracking and shoulder motion
Strengthening programs can be introduced at this point
Prevent further injury with better posture and activity changes
We recommend getting your shoulder checked out by a specialist to work on the joint restrictions and improve muscle pain through trigger point dry needling and assisting you with developing a specific home program that is just for you and your problem.
Call 719-596-5000 for a shoulder diagnostic ultrasound and evaluation!
Dry needling is a great way to reduce muscle knots quickly! Shoulder dry needling will reduce muscle knots and decrease pain fast. For more on dry needling check this link out.
