Here’s a possible reason why – and how to fix it.

Persistent shoulder pain is a very common condition that can have a really detrimental impact on your quality of life because it can limit your participation in sport, recreation, and all sorts of other everyday activities.

Common causes of persistent shoulder pain include rotator cuff tears, shoulder instability, tendon impingement, arthritis, labral tears or bursitis. Injuries to the shoulder often result in muscle imbalances which, if not addressed, contribute to the ongoing nature of the pain.

As specialist musculoskeletal physiotherapists, we will be able to identify the cause of your shoulder pain through a thorough assessment of the muscles, joints and nerves of the upper limb and spine.

Once the cause of the shoulder pain is identified, we can work with you on an individual treatment plan. This typically involves manual therapy and massage as well as specific exercises to strengthen and stretch the shoulder blade, spine and rotator cuff muscles

Diagnosing ‘scapula dyskinesis:

Scapula dyskinesis is a term that describes a physical impairment in which the position and motion of the scapula (shoulder blade) are altered

Over the past 30-plus years of treating patients, we have observed that an alteration in the shoulder blade (scapula) position is a very common cause of persistent shoulder pain that is often left undiagnosed – and, therefore, untreated. 

The shoulder blade is a flat triangular bone that acts as an “anchor” for the shoulder. It provides the foundation for all shoulder movement. 

The position of the shoulder blade (either resting or during shoulder movements) is largely dependent on the muscular attachments of the spine and rotator cuff muscles. Tightness or weakness in any of the muscles surrounding the shoulder blade can adversely alter its position, placing increased strain on the rotator cuff tendons, as well as the shoulder joint itself.

We have found that unless the shoulder blade is stable and moving in a coordinated manner, many shoulder joint and tendon problems do not recover and the associated pain persists. 

The assessment of any shoulder disorder should include a detailed examination of the position of the shoulder blade at rest, as well as during shoulder movements, with a focus on which activities and postures cause pain. 

Once these problems are identified, they can be addressed with the use of exercises to improve the shoulder blade’s position and control during movement. In some cases, we will also use massage or encourage stretching of tight muscles as an adjunct to the exercises.

Once the shoulder blade has returned to an optimal position and is moving relatively freely, exercises that are directed at the rotator cuff and shoulder joint are much more effective in returning the shoulder to normal function, without pain.