Pain
to the shoulders

Although there may be inflammation as in the case of bursitis or tendonitis, the cause of this pain lies in the lack of mobility in the joints surrounding the shoulder. In the next two articles we will look at the relationship between these joints and shoulder pain. The main goal of the osteopathic approach is to give the shoulder mobility by increasing the amplitude of the following structures

• From the chest
• From the scapula

It is important that the thorax is mobile because several shoulder muscles are attached to it. The thorax is composed of the ribs, vertebrae, heart and lungs. Organs inside the chest are attached to it by fasteners and can slow down the range of motion of the rib cage.

First of all, in order to ensure the necessary amplitude of the thorax, the mobility of the diaphragm is essential. In addition, special attention is paid to the articular mobility of the first two ribs because of their innervation, vascularization and their role in the mechanics of the shoulder. Optimal mobility of the scapula is essential because its movement is twice that of the arm. The rotator cuff muscles attached to the shoulder blade are used to stabilize the arm.

In addition, the rotator cuff ensures smooth movement of the scapula and arm during elevation. We also evaluate certain muscles from the neck, head and chest.

So the scapula is important in shoulder pain.

Shoulder pain can be caused by a lack of spinal mobility in the thorax and scapula. Today we will see the relationship between the shoulder, the clavicle, the neck and the head. First of all, the clavicle is an important muscular relay for the muscles coming from the upper limb and attaching to the thorax, scapula, neck and skull.

Restriction of mobility of the clavicle can lead to numbness, which is frequently experienced at night, causing restriction of mobility of the nerves and blood vessels of the arm, the thoracic outlet syndrome. Shoulder pain such as tendonitis or bursitis will occur because the rotator cuff tendons passing under the collarbone are irritated and pinched. Cervical mobility is important because there are several nerves that run from the neck to the shoulder and arm.

The origin of shoulder pain is mainly caused by the irritation of certain nerves in the neck that directly innervate the shoulder. Finally, several muscles that attach to the head influence the mobility of the shoulder. Figuratively speaking, the skull is a ball-shaped puzzle where several bony pieces fit together.

Since a muscle has two movable ends, the muscles that attach to the scapula, neck, clavicle, head and arm must be movable. For example, a person who falls on his or her head may develop shoulder pain. In addition, the ligaments attaching the heart and lungs to the rib cage attach to the neck and skull and demonstrate the connection between the head, skull and thorax.