Shoulder Pain


Shoulder pain affects a large number of our population, and almost all of us have had some experiences of shoulder pain in our lives, and the severities can range from a temporary discomfort to serious debilitation.

The most commonly seen shoulder conditions include tendonitis and tendonosis, impingement syndrome, arthritis, rotator cuff syndrome, frozen shoulder, and bursitis (most commonly deltoid bursitis).

The elderly population typically suffers more from degenerative types of diseases such as arthritis, which is usually associated with pain and decreased range of motion. Among middle aged population, it is more common to see rotator cuff syndrome or tear, as well as frozen shoulder. The formal diagnosis for frozen shoulder is adhesive capsulitis, which is characterized by generalized inflammation of the shoulder joint capsule that results in severe pain and drastically reduced range of motion in all directions of shoulder movement.

For those who are actively involved in athletic and sports activities, especially activities that involve overhead movement or throwing, such as swimming, baseball, volleyball, tennis, etc., impingement syndrome and bursitis are most common types of injury. However, more severe problems can occur as well, including rotator cuff tears and labrum tears.

Rotator cuff is the name of a group of 4 relatively small muscles at the shoulder that are primarily involved in stabilizing the joint. Repetitive inappropriate use of the shoulder can cause tear of any of the 4 muscles at the tendon areas, most commonly at the supraspinatus tendon. Labrum is a cartilaginous extension of the shoulder joint “socket”, which can be torn due to trauma or repetitive injuries.

Falls on the shoulder, especially with outstretched arms, could also easily cause shoulder dislocation or tear of the acromioclavicular joint, and any type of shoulder dislocation can lead to instability that cause long term problems including early development of arthritis and decreased range of motion.

Shoulder problems are frequently intertwined with neck problems, because neck and shoulder are so close to each other, not only with regard to location, but also in terms of their biomechanical function. Many muscles bridge between the neck and the shoulders, and there are many movements of the shoulders that require the help of the neck. Conversely, neck tension frequently causes shoulder problems as well (please see the article on Neck Pain).

To shed some light on the causes of shoulder pain, let us take a closer look at the features of the shoulder joint. The shoulder joint possesses the largest range of motion in the entire body. Each shoulder is actually functionally comprised of 3 joints to achieve this amazing range of mobility. The shoulder provides a stabilizing pivot point for movement and strength of the entire upper limb, therefore good stability and strength is the key for allowing good use of the arm to wrist.

But On the other hand, how far we can outreach with our hands largely depends upon the flexibility and mobility of the shoulders. Stability and mobility, two seemingly opposite qualities, are both required for a shoulder joint to meet all our needs, which require the good coordination of many muscles to achieve. This is the reason why almost any problems with your shoulder always involve multiple structures (joints, muscles, tendons or ligaments) in or around the shoulder joint.

So what is your diagnosis?

Now you know that most shoulder pain involves multiple structures and many of the diagnoses are interrelated functionally – what you are labeled by your diagnosis may not be most relevant to how you should be best and effectively treated. Would you like to stop the pain and maximize your recovery in minimum time?

Our highly trained doctors with years of successful experiences will analyze your case individually with our expertise in biomechanical diagnosis and implement a unique treatment plan for you and you shall feel the difference within a short period of time if not right away.

Want to stay out of pain, enjoy what you do, and stay out of sight of doctors including us (our goal)? You need to be educated, trained and coached to implement the simple yet important programs so you are pain and injury free.

There are many conventional treatment that have been frequently used for shoulder pain such as stretching, ultrasound, heat, electrical muscle stimulation (EMS), exercises, and non-specific soft tissue work. Many are helpful but not specific enough to resolve the problems for the effective and quick recoveries we are looking for.

For example, stretching is good for overall flexibility, but does not have enough specificity to target the specific muscles that need it the most, therefore it is much better used as an adjunct to reinforce the treatment but not as the treatment itself. Ultrasound, heat and EMS are largely for symptom control by reducing the inflammation or improving circulation, without resolving the root problem. As a result, the problem is prone to recurrence, should you go back to the old activity that you are told to have caused your problems in the first place.

Exercises are excellent for your recovery, but appropriate exercises are only beneficial after the unique/specific problem is corrected and you are pain free. If exercises are implemented too early, they can cause adverse effects such as worsening an impingement syndrome, and may even prolong the time of suffering.

Conventional soft tissue work including massages are great for relaxation and reducing the muscle tone, but do not target the most important and relevant muscles specifically enough for your problem. They do not work fast enough, because they usually do not get to the heart of the problem.

We all know that surgery is the very last resort. The drawbacks include large amounts of scar tissue formation, prolonged rehabilitation and re-adaptation. In addition, surgical intervention for some problems are more like band-aids, because the underlying biomechanical problems are not corrected, and the symptoms can easily recur unless the patient completely stays away from the “offending” activities. However, there are no offending activities in our eyes. No activities you enjoy should ever remain off limits, once you have been effectively treated. Our goal is to help you resume all activities that bring you happiness to your life.

Active Release Technique

Active Release Technique (ART), on the other hand, is the most specific, targeted and effective soft tissue technique for your shoulder pain and other body pain.

When this highly effective treatment method is combined with precise biomechanical diagnosis that takes the whole body into account and most efficiently identifies and targets the key structure responsible for your problem, the result is fast recovery from your pain, be it debilitating or just nagging.

Come to our office and see for yourself how quickly you can be free from your pain and suffering.

Contact us today for our shoulder pain treatment plan and information.
(858) 481-1438



Dr. Dawn Liu, Ph.D., D.C., L.Ac
Dr. Anna Phillips, D.C., M.S.
David Snyder, L.Ac., C.Ht
Action Chiropractic & Wellness
312 S. Cedros Ave, Ste 326
Solana Beach, CA 92075

Call: (858) 481-1438