Muscle pain and imbalance in the shoulder

I got inspired to write this post after seeing an old friend a couple of days ago. He has a shoulder problem and it started some time ago, got better but came back. (For us physiotherapists this is a very common scenario.) He noticed that trigger point treatment of some of the rotator cuff muscles (joint stabilizing muscles in the shoulder) helped. However, when the pain came back – it was worse, now with more muscles involved and he had trouble lifting his arm as a result. This could very well be the symptom of a lot of different diagnosis.

So, what to do?

As I've explained before in the previous post, this could be a typical history of pain due to imbalance around the shoulder joint, and the shoulder joint is very dependent on the shoulder blade and it's function, as well as eventual shortness and/or stiffness of the pectoral muscles.

Now, if I treat the symptom of trigger points in one or two muscles, I still haven’t addressed the underlying problem and the pain will keep coming back. The incorrect movement pattern is still there, ruining the balance. 

Altered pressure, joint force and muscle work around the shoulder can give many secondary symptoms; various inflammations and irritations in rotator cuff tendons, bursitis, impingements, small partial ruptures etc. 

If the pain is due to imbalance, then a massage, acupuncture, trigger point treatments etc. can ease the symptom of pain, but you also need to work on your body (in this example the shoulder joint) and get it in balance again to get to the root of the problem.