The shoulder is composed of several joints between the collarbone, shoulder blade, and arm. Ligaments overlap the joints to form joint capsules. Smaller muscles overlap the ligaments-most notably the rotator cuff muscles connecting the arm to the shoulder blade. On top of those muscles are bigger muscles known as global movers, which give us full function and power. Global movers provide gross force and direction while the smaller, underlying muscles provide minor corrections to smooth out and refine movements.
The shoulder is a complex and enabling joint. Its range of motion is greater than any other joint, allowing vast movement possibilities. The trade-off for such flexibility is less stability. Balanced muscular function is necessary not only for proper movement, but for providing structural support to the joint.
The path toward shoulder pain typically begins when the global movers are inhibited. Muscle inhibition is a nerve communication problem which results in weakness. It's not a muscle strength issue, otherwise a person could exercise their way out of pain. Instead, for one of many possible reasons, the muscle isn't getting the brain's message and fails to adapt when increased force is applied. Unfortunately, an individual doesn't feel muscular inhibition, but they can identify the effects or warning signs. Red flags include a feeling of upper arm weakness, tightness, or simply an indescribable feeling that something there "just isn't right." Can you put one arm behind your back and the other over your head, then grip both hands together? Inability to connect the hands signifies early shoulder dysfunction. Pain will likely develop with increased activity, if it isn't already present.
Muscles "turn off" like this for a multitude of reasons, and unfortunately, the average medical doctor, orthopedist, physical therapist, and athletic trainer have little to no education in this field. The expert to seek out is a professional applied kinesiologist or "AK doc," for short. Most AK docs are chiropractors with knowledge of acupuncture and nutrition. These are individuals trained to properly test the involved muscles for inhibition and rapidly diagnose the cause. Frequently, a solution will require joint adjustment, acupoint stimulation, homeopathic remedies, vitamins, minerals, herbs, or some combination.
If the global movers remain inhibited, the smaller muscles of the rotator cuff compensate by trying to do the work of the bigger muscles. Unfortunately, they don't have the power or mechanical leverage to achieve joint balance.
Ever drive a car for long periods with the alignment off? Doing so causes irregular tire wear and eventually a blowout. It's the same with joints. The shoulder will become inflamed and painful, not to mention prone to injury. Rotator cuffs are torn when a pitcher throws a ball and doesn't have global mover support. Imagine falling when global movers aren't up the task of cushioning the impact. When muscles fail to support joints and a stress is delivered to that joint, bones may break, and the muscles, tendons, or ligaments tear.
When any muscle fails, surrounding muscles must compensate by either increasing or decreasing muscle tone. Sometimes, if we eat and exercise properly, relieve mental stress, and get enough sleep, the body is able to heal on its own and reverse the process. However, in our modern lifestyles, this can be difficult. If a global mover fails, the smaller muscles do their best, but eventually become tight and fatigued or lethargic and weak. Time passes. Minor pains become sharp. The cuff becomes impinged, tears, or the arm can no longer be raised fully. When the arm can no longer be lifted above the shoulder, it is known as a frozen shoulder. These normally require 1-2 years for "thawing," but a good AK doc can usually fix it in 2-6 months. To find an AK doc, Google "ICAK-USA," and "Find an AK doc."
