You’ve heard the phrase before, “it’s all connected”. This phrase is certainly true for shoulder injuries.

It’s hard to believe at times but issues at certain joints (e.g. hip) can manifest as pain in other joints (e.g. knee).

Our anatomy is complex and there is a vast amount of ligaments, nerves, bones and muscles that mould together like a perfect jig-saw. To function normally and without pain, all of these structures have to work in harmony to allow you to move and live your life.

If you’re reading this blog there’s a good chance that you are doing so because you want to find the root cause of your shoulder pain. There are many reasons why you could suffer from shoulder injuries and there is any number of structures that could be involved.

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A key thing to consider however and the focus of this blog is that shoulder injuries can be referred or caused by limitations in other closely related joints. Your shoulder is the most mobile joint in the body and allows movement through 180 degrees in a variety of different directions.

It is also intrinsically linked to your neck, with many muscles that attach to your shoulder blade and collarbone originating from the neck (see image below).

This network of muscles is important to consider when you have shoulder pain. For example, when your body senses danger (e.g. an injury) in a region such as the neck it can respond by causing the muscles around the area to go into spasm.

Spasm is a state in which muscles are caught in a state of contraction. This is a protective response to encourage us to limit movement in that region while the tissue heals. However sometimes this “protective response” can linger on after an injury is healed (e.g. whiplash) and the muscles can remain in a state of spasm. 

As you can imagine this state of spasm changes how we move and can cause certain muscles to work more than they usually do causing shoulder injuries. Simply put, if a certain group of muscles aren’t firing on all cylinders there will be another group of muscles that will have to pick up the slack.

Over time this can lead to muscle imbalances and altered movement patterns which can lead to shoulder injuries. In clinic we often see that the neck is the culprit, with the shoulder been the victim.

So identifying and addressing any old injuries in other joints is something we aim to do early in our physiotherapy assessments. Often by improving mobility and strength at the neck we see big improvements in shoulder movement and pain.

Shoulder injuries can also be the result of nerve issues in the neck and so treatment is much different to somebody with a rotator cuff tear.

We often see in our clinics in Cork and Fermoy patients who have tried shoulder exercises that they find online. While this may work in some cases, if the exercise is not addressing the root cause it often won’t help. (Here’s a video we did recently on the topic!)