Shoulder

What is it?

The shoulder is the most mobile joint in the human body, allowing us to perform actions such as raising our arm, reaching for objects, pushing, lifting weights, or carrying out precise movements with our hand.

To function correctly, it requires a balance between mobility, stability, and coordination. This process involves structures such as the scapula, clavicle, thoracic spine, rib cage, and numerous muscles working in a synchronized manner.

When this balance is disrupted, discomfort can arise that does not always originate from the shoulder joint itself, but rather from the way the entire system works together.

Most Common Symptoms

Pain when raising the arm.

• Discomfort when lifting weights or performing overhead movements.

• Stiffness or loss of mobility.

• Sensation of weakness in the shoulder.

• Pain when sleeping on the affected side.

• Sensation of impingement or catching.

• Pain that can radiate to the arm, neck, or scapula.

• Tension in the neck and shoulder musculature.

Why does it appear?

Shoulder pain can be related to various factors, including:

• Altered movement patterns of the scapula (scapular dyskinesis).

• Muscle overload.

• Rotator cuff tendinopathies.

• Biceps tendon irritation.

• Joint stiffness.

• Strength or motor control deficits.

• Lack of thoracic spine mobility.

• Physical or emotional stress.

• Nervous system sensitization.

In many cases, pain is not solely caused by a structural injury, but also by the way the shoulder distributes loads and coordinates with the rest of the body.

The Importance of the Scapula

The scapula (shoulder blade) acts as the foundation upon which the shoulder moves. For the arm to function properly, the scapula must move coordinately with the thoracic spine, the rib cage, and the stabilizing musculature.

When this coordination is lost, other structures begin to compensate, increasing the load on tendons, muscles, and joints.

In addition, the nervous system directly influences muscle tension and the way we move. Prolonged stress, lack of rest, or persistent pain can promote stiffness in the neck, trapezius, and shoulders, causing symptoms to persist. Therefore, treatment aims to restore the function of the entire system, and not just relieve the painful area.

Therapeutic Approach

Techniques to relieve pain, restore function, and prevent recurrence:

• Manual therapy.

• Myofascial release.

• Deep dry needling, when indicated.

• Specific scapular work and motor control training.

• Therapeutic exercise.

• Percutaneous Therapeutic Electrolysis (EPTE), when indicated.

• Pain and movement education.

• Functional shoulder re-education.

Treatment Goals

Reduce pain.

• Restore shoulder mobility.

• Improve scapular stability and control.

• Optimize movement coordination.

• Reduce muscle tension.

• Promote a safe return to daily activities and sports.

• Reduce the risk of recurrence.