Culprits of Your Shoulder Pain

"When you come to the end of your rope, tie a knot and hang on." ~Franklin D. Roosevelt

Shoulder pain occurs when weak muscles contract too much, are overstretched, and sometimes are torn. This happens because we tend to neglect our muscles and the important role they play in keeping us moving.

Many desk workers, medical professionals, hair dressers, bridal consultants and almost any profession that uses their upper arms will experience some form of shoulder neck pain.

I created this page to discuss and identify the muscles involved in shoulder pain. By understand how these muscles work together you can devise a plan to relieve your shoulder pain and also to implement an exercise regimen to prevent it from happening again.

The Muscles

Trapezius

The trapezius, also called the Traps for short, is a major muscle of the back. This muscle is a large triangle shaped muscle that starts from the base of the neck all the way down to about lower mid back. This muscle is responsible for stabilizing, raising, retracting, and rotating the scapula. When working together the upper and lower trap muscles rotate the arm.

Referred pain patterns include:

Headaches: These headaches begin at the front of your forehead to the base of your skull and throbs.
Neck pain: This pain runs the entire length of your neck and down to the upper part of your shoulder. You'll also notice that you tend to raise your shoulders to your ears.
Mid back pain: You can feel this pain in the middle of your back and may have pain in your scapula.

Levator Scapulae

This is a very important muscle that helps shrugs the shoulder and bends the neck side ways and rotates it as well. This muscle begins in the neck and inserts itself into the top part of the scapula.

If you run your hands on your shoulder and feel a lump in your shoulder that's your levator muscle. This muscle has a natural twist in it. Do not let any therapist tell you that they can straighten it out because it is not possible.

Referred pain patterns include:

Pain at the base of the neck and behind the ears.
Pain at the border of your scapula
This pain is achy and can be dull.

Pectoralis Major and Pectoralis Minor

These muscles, also known as the pecs, are located in the chest area of the body. This muscle starts at the center of the chest (the sternum) and inserts itself into the humerus (the upper arm bone).

When this muscle contracts and stays contracted it gives you that "hump" shoulder look. The pectoralis group causes shoulder pain by overstretching your back muscles. This is common among many desk workers who do not sit up straight.

Referred pain patterns include:

Pain in the chest.
Trouble breathing.
Pain in the middle of your back due to overstretching.

Latissimus Dorsi

Lady Dorsi, as it is sometimes called, is a very large muscle that begins mid back, extends to your hips and inserts into your humerus. This muscle extends, adducts (brings your arms towards your body), medially rotate (turns your arms inward towards your body), and draws the shoulder downward and backwards.

Some of your shoulder pain can come from this muscle when you have trouble moving your arm. Some of the trigger points for this muscle is located near the armpit.

Referred pain pattern includes:

Pain in your mid to low back and around your hips.
Pain around the shoulder blade and sometimes into the shoulder joint.

Rhomboideus Major and Minor

This muscle is a small muscle but it helps adducts (bring together), retracts, elevates, and rotates your scapula. It also stabilizes it. The muscle fiber starts around the upper mid back and inserts itself into the middle border of the scapula. This muscle is affected when the pec muscles are contracted causes the rhomboids to become overstretched.

This muscle group is a major culprit in shoulder pain.

Referred pain patterns include:

Neck pain and shoulder pain.
The pain is achy, dull and can be sharp at times.
Pain can be felt in and around the scapula.

Serratus Posterior Superior

This muscle is usually not touched because of its location. It lies beneath the rhomboid muscles next to the ribs. To get to this muscle group you need some good digging fingers. It's definitely hard to self massage this one but can be done. Its referred pain pattern is located under the upper portion of the scapula.

The Rotator Muscles

These muscle group is made up of 4 muscles in the shoulders. They are the subscapularis, infraspinatus, supraspinatus, and teres major. This muscle group is responsible for rotating your arm and stabilizing the head of the humerus muscle. When you hear someone say they have a rotator cuff injury or frozen shoulder, these muscles are the culprits.

Subscapularis

The subscapularis sits directly underneath the shoulder blade. This muscle is hard to work on and can not be felt without some pressure into the area. It is really hard to self massage this muscle. The trigger point for this muscle are in the belly of the muscle and it's referred pain is usually at the shoulder joint and sometimes on the shoulder blade itself.

Infraspinatus

The infraspinatus sits on top of the shoulder blade. It is located below the bony portion of the scapula on the infraspinous fossa. This muscle can be felt by running your hands or thumbs along the muscle fibers. When this muscle is in a constant state of contraction you can feel "knots" along the muscle fibers. It's referred pain pattern is deep in the shoulder and deltoid muscle of the arm (the upper most part of the arm).

Supraspinatus

The supraspinatus muscle sits on the upper portion of the scapula on the supraspinatus fossa. This tendon is the one that is frequently torn in rotator cuff injuries. It is a small muscle but can cause tremendous amounts of shoulder pain. Referred pain patterns occurs deep in the shoulder and down the arm to the elbow. Pain becomes worse during the action of adduction.

Teres Minor

This muscle originates at the outer border of the scapula towards the arm and the muscle inserts into the upper region of the humerus called the lower facet of the greater tubercle. This muscle can be felt during lateral rotation of the arm. Its referred pain pattern is in the deltoid region of the arm.

Erector Spinae

This is a large group of muscles that extend from the mid neck all the way to the sacrum. These muscles help hold your body upright and bend sideways and backwards. I included this muscle group because when the upper portion of these muscles are tighten they will cause pain around the shoulder/neck area putting stress on the shoulder muscles.