Some of the most common problems that we see are due to poor motor control, especially of the scapula. Just an anatomy and biomechanical review: The shoulder complex is comprised of 3 very important joints that all need independent motion. These joints are the Glenohumeral Joint (the joint that you mostly hear about with injuries), the Acromioclavicular Joint (the bony connection to the rest of the body), and the Scapulothoracic Joint (the problem child). Problems arise when we do not know how to control the muscles influencing movement of these joints. The lack of control is due to compensation or poor motor strategies over time. The most common compensatory presentation that is seen is best described by Janda. He terms the condition Upper Cross Syndrome. Simply explained, the Pecs, Upper Traps, and Levator Scapulae are all tight (or neurologically facilitated), while the Deep Neck Flexors, Middle/Lower Trap, and Serratus Anterior are all weak (or neurologically inhibited). View picture below for reference.
Here is a question to ponder for the colleges: How do you think constant use of secondary respiration muscles influences the neurological tone in Janda’s facilitated muscles? Are we creating a lower threshold for activation of these muscles in other daily activities?
The painful source of this type of presentation can be anterior shoulder pain, upper trap pain, neck pain, headaches, TMJ dysfunction, etc. The painful source is determined by which structure is compensating the most and what daily activities you find yourself doing most. We preach this often, but Band-Aid care will not fix this issue. Adjustments, soft tissue work, single joint exercises and dry needling is not what you should be seeking for care. This, like many other conditions, is due to how you use your body. Stability of the scapula through an overhead range of motion is easier said than done! The goal is to change your movement strategy. By default, tone and trigger points will dissipate… for good, unless poor movement strategies are resumed.
The goal of treatment should always be fixing the problem long term. This can only be done by changing the way your brain chooses to move your body through space. It is our goal to make sure you can continue to swing a golf club for the rest of your life, to not be in fear of picking up children and grandchildren, and to be the weekend warrior you’ve always dreamed of being.
This site does not represent individualized professional medical advice. Please seek medical attention for any concerns regarding your personal health. Do not avoid, delay, disregard professional medical advice, or delay seeking it because of something you read on this site. If you want to be evaluated and receive personalized treatment, please call the office or send us an email.