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Chiropractic and Shoulder Problems Part 1

© Dr. David L. Phillips

This is the beginning of a 4-part article about shoulder pain and dysfunction. In these articles, I will discuss why it is that shoulders so frequently hurt, what leads to problems with this joint, and what you can do to help yourself with pain, or, better yet, prevent trouble from starting. Because this is a 4-part series, I plan to post these articles on a weekly basis, rather than my usual twice-monthly schedule.

To more fully understand these articles we need to cover some basic concepts of muscle physiology and kinesiology. I will keep this as simple, yet accurate, as possible. You may learn way more than you ever wanted to know, but what the hey, knowledge is power, right?

Shoulders are the third most common area of the body that chiropractors treat. Lower backs and necks being first and second, of course. Like most structural complaints of the body, shoulder pains come from muscle imbalances. These imbalances build up over time as your body compensates, until the effort of compensation becomes just too much, or the wear and tear factor overwhelms the local tissues, and the pain begins.

Pain comes from many sources, but in the shoulder, pain is usually represented as a circle. The classic circle of pain is frequently described as a closed system consisting of three-parts: spasm, inflammation and pain. These 3 factors are often shown connected in a circle with arrows going both ways between all three aspects. That scenario works for acute pain, but in cases of chronic pain, the spasm part is much more along the lines of what is known as hypertonicity. Just as the word would suggest, hypertonicity is a condition in a muscle in which the muscle has too much tone. Muscles in this state, and we all have them, especially in our shoulders, are tight, less flexible and can ache, sometimes ceaselessly.

Spinal muscles too are prone to conditions of hypertonicity, as they are a type of muscle known as "tonic" muscles. This is opposed to "phasic" muscles. Tonic muscles can maintain a state of contraction for long periods of time and not fatigue, due to their cellular make up. Tonic muscles in a chicken are the dark meat, phasic the white. Some shoulder muscles are tonic, but most are phasic. Phasic muscles are capable of quick and intense contractions, but only for short periods before fatigue sets in.

The most common problem in the shoulder is called variously bursitis, tendonitis, or rotator cuff tendonitis. The latter term is heard often these days, especially in connection with sports. Actually, there are 4 muscles that make up the rotator cuff; so to more accurately use this term one usually attempts to identify the specific culprit. To be precise then, supraspinatus tendonitis is the most common problem in the shoulder.