Shoulder pain

For rotator cuff strain, impingement and the shoulder that aches after a day at a desk or a session in the water. We assess the neck and shoulder blade with it, alongside your physician or physical therapist.

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Read through

BothWesternClassical

Two lenses, one plan

Wood 木 is the phase it is most often read through. Here the Western lens leads, with the classical lens alongside.

The Western lensAnatomy, physiology, biomechanics

The cuff, the blade and the neck

The shoulder joint is a ball on a shallow socket, held centered by the rotator cuff while larger muscles move the arm. It depends on the shoulder blade rotating and tilting under it, and on a thoracic spine that can extend.

Scapular rhythm: As the arm rises, the shoulder blade is meant to turn upward with it. When the lower trapezius and serratus anterior are inhibited, the blade lags and the space under the acromion is thought to narrow.
Cuff tendons: Overuse can make the cuff tendons, the supraspinatus most of all, sensitive to load and compression. Tears range from partial fraying to full thickness and are confirmed with imaging.
Referral from the neck: The lower cervical nerve roots supply the shoulder muscles, and an irritated root or a trigger point in the neck can be felt over the shoulder and down the arm.

The classical lensChannels, patterns, the five phases

Channels across the shoulder

Three yang channels cross the shoulder: the Large Intestine at the front, the Triple Burner on top and the Small Intestine over the shoulder blade. Which one hurts helps decide where the points go.

Wind and cold at the shoulder: Shoulders that ache after cold wind, a night in front of a fan or a long session in cold water are read as wind-cold lodging in the channels, 風寒.
Treating from the leg: Points on the leg along the matching channel can be needled while you move the arm, an old strategy that Master Tung's system uses often.

Patterns we often see

Qi stagnation and blood stasis in the shoulder channels qì zhì xuè yū 氣滯血瘀
Wind, cold and damp obstructing the channels fēng hán shī bì 風寒濕痹
Liver blood deficiency leaving the sinews undernourished gān xuè xū 肝血虛

Patterns are examples of how this is often read, never a diagnosis. Yours is read at your visit.

How we work: one plan

Movement screen first, then one visit that combines dry needling and orthopedic acupuncture of the cuff, shoulder-blade and neck muscles, Active Release Techniques and functional movement corrections for the shoulder blade, with electro-acupuncture where a muscle needs it and distal Master Tung's points for a shoulder too sore to touch. Your physician or orthopedist handles imaging and suspected tears.

What shoulder pain usually is

The shoulder trades stability for range. Four small rotator cuff muscles hold the ball centered in a shallow socket while the arm moves, and their tendons pass through a narrow space under the bony roof of the shoulder. When the cuff tires or the shoulder blade stops rotating and tilting as it should, those tendons can get pinched with each reach overhead: impingement. Overuse can also irritate the tendons themselves, and the biceps tendon at the front of the shoulder joins in often. Your physician or an orthopedist handles imaging and suspected tears; physical therapy often runs alongside our work.

Sorting the shoulder

Shoulder pain covers several different problems, and the plan changes with each:

Cuff strain or impingement. Pain reaching overhead or behind, an arc of discomfort partway up, aching on that side at night.
Frozen shoulder. Stiffness in every direction, including when someone else moves the arm for you.
Neck-driven pain. Pain over the shoulder blade or down the arm with tingling, which points to the neck or a pinched nerve.
Posture-driven tightness. A rounded upper back and forward head at a desk, or the same in paddlers and swimmers after long sessions.

How we work with it

The movement screen looks at the upper back, the neck and the shoulder blade as well as the joint. Then, in one visit, dry needling and orthopedic acupuncture of the cuff, the shoulder-blade muscles and the neck segments that supply them, Active Release Techniques where tissue has stopped gliding, and functional movement corrections for the shoulder blade. A shoulder too sore to touch is started with distal points on the opposite side or the leg.

We measure how high you can reach, how far behind your back, and whether you sleep on that side, and recheck each visit.

Questions people ask

Can acupuncture help rotator cuff pain?

Needling the cuff and shoulder-girdle muscles, combined with hands-on release and exercises that change how the shoulder blade moves, is a common approach for cuff strain and impingement. A suspected full tear needs your physician and imaging first.

Why are you treating my neck when my shoulder hurts?

The nerves to the shoulder muscles come from the neck, and a stiff neck or upper back changes how the shoulder moves. Pain felt in the shoulder can also start in the neck, so the two are assessed together.

Can I keep surfing or lifting?

Often yes, with changes. We look at which part of the stroke or lift provokes the pain and adjust it, rather than ask you to stop by default.

Could my shoulder pain be something serious?

Left shoulder or arm pain that comes with chest pressure, shortness of breath, sweating or nausea can be a heart problem. Call 911. A shoulder that suddenly cannot lift after a fall also needs medical care first.

From the journal

This is general wellness information, not medical advice.

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