Shoulder Pain – Myths & Facts


Shoulder pain is extremely common in our society, it may not generate quite the same impressive disability stats that back pain does but it definitely impacts a lot of lives. A sizeable portion of the suffering caused by stubborn shoulder pains comes by way of persistent annoyance and discomfort during day to day life. Another miserable aspect of shoulder pain is the frustrating limitations it creates for us around lifestyle choices, exercise and hobbies. I don’t believe we are supposed to struggle with challenges of this nature in life. There are so many more beautiful, interesting and worthwhile things we could do with our lives than spend our days being made miserable by relatively simple little mechanical problems in the body.

A significant part of the reason why so many people struggle with shoulder pain is just a straightforward lack of broad cultural understanding of the basics. When we show up at the dentist with toothache the majority of us have a pretty clear understanding of the ‘condition’ we are being treated for. When we attend a clinic for shoulder pain however there tends to be a far greater level of uncertainty around what is actually happening to the tissues. Did you know for example that virtually all shoulder pain issues are caused by chronic postural changes? And that even the major shoulder injuries and tears are almost all primed by postural weaknesses and habits?

Let’s look at a couple of lesser known but useful things we could learn about shoulder pain.


Bursitis Facts

Bursae are small, fluid-filled sacs that are placed throughout the body in places where there is a great deal of friction. They act as lubricated pads between bones and soft tissues, and help reduce friction during movement between the shifting muscle tendon and bone.

Bursitis is a condition where the bursa becomes inflamed due to excessive pressures use being placed upon it. Bursitis can lead to shoulder pain and limitation of pain free movement on track shoulder.

The conventional explanation for burstitis that you will find all over the internet is that straight forward ‘overuse’ is what causes shoulder bursitis. The reality is though that there is always a million other humans overusing their shoulders, and not getting bursitis. This is the case, because the true cause of bursitis is postural imbalances and poor movement habits, that put excessive compression on your shoulder.

bursitis shoulder pain x ray image

The alignment of your bones and muscles determines whether you suffer from shoulder pain and bursitis.

The other commonly observed myth about bursitis is that if you have an enlarged bursa on you ultrasound scan that must be the cause of your pain.

The far more complex and nuanced truth is that many people with enlarged bursae in their shoulder do not have bursa pain, the bursa is enlarged but it’s soft tissue pain that they are experiencing. This fact is hinted at by the extremely hit & miss nature of cortisone injection into the bursa.

The good news is that an approach that seeks to correct the underlying postural issues can be extremely effective for managing bursitis and bursae related pain. Mobilising the shoulder joint and upper rib cage are the important first step. This is followed by exercises for postural correction.


Rib Pain Facts

One of the most common pains we see at our office is that classic ‘annoying’ ‘niggly’ persistent shoulder knots that seem to feel worse doing things like desk work. A percentage of these can be quite extreme and can seriously affect your sense of  happiness and wellbeing.

The reason that so many of us get stuck with these knots even after treatment, is that they they are not actually muscle knots. THE RIB CARTILAGE IS STUCK where it attaches to the spinal column. That’s why there is often very little relief with treatments like massage and acupuncture for this particular complaint.

Many people with this complaint feel that they want deep massage, but it can never seem to be deep enough.. as if there is something it isn’t reaching … the stuck rib cartilage !!!

The rib cartilages are small knuckle sized joints that attach your ribs to your spine, they enable the movement of the rib cage. Rib cartilage issues are usually something that has built up over time, often in relation to poor posture. Sometimes old injuries play a role too.

shoulder pain / rib pain

Shoulder pain is often caused by issues with rib movement.

These kind of rib problems are usually easy to treat. For most people treatment is a step by step process of loosening up tight muscles – mobilising the ribs – strengthening the upper back muscles. For many office bound shoulder pain sufferers it is often necessary to get a small amount of maintenance treatment and continue with strength exercises in the long term.


Closing Thoughts

My final thoughts are those of encouragement and hope. If you have been struggling for a long time with shoulder pain there is every chance that you can find a way to resolve it. Doing so will give you a great sense of freedom and relief. The only up side to these type of struggles is that they teach us to appreciate the the basic appreciation of healthy movement and physical comfort.

shoulder pain exercises

A willingness to work at the strength of our shoulders is the ultimate goal of treatment for shoulder pain.

Be willing to try different approaches and if necessary different practitioners. There are many ways to treat shoulder pain and many subtle differences in how shoulder pain manifests, these can create quite unique treatment needs. Having worked with countless shoulder pain sufferers my advice is to keep the faith, keep and open mind and be persistent in your approach to seeking relief.

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