Fascia Therapy for Shoulder Pain  

Relieving shoulder pain requires a careful, thorough approach for this complicated joint. The shoulder moves more freely than any other joint in the human body, and both its movement and stability are controlled by over a dozen muscles.  

Whether dealing with tendonitis, arthritis, or mild tears of the rotator cuff, successful treatment of most shoulder problems hinges on treatments that restore muscle function and balance. Restrictions in the connective tissue called fascia—often due to prior injuries—are frequently the cause of shoulder muscle dysfunction. Finding and treating these restrictions can restore muscle balance and strength, which relieves shoulder pain. To illustrate the complexity of shoulder issues, let’s look at the cases of three patients, whom I will refer to as Pat, Larry and Sue.  

Pat could not raise her left arm to her head, resulting in a diagnosis of tendonitis. Larry could not reach behind him or even into the back seat of his car. He was told that he had bursitis in his right shoulder. An MRI of Sue’s right shoulder showed a small rotator cuff tear. She was unable to lift a coffee mug or drive her car without experiencing intense pain. Each of these three patients suffered from different problems, but the roots of their pain could all be traced back to fascia—a fibrous connective tissue that covers muscles, nerves, bones, joints, and most other tissues in the body. 

Tendonitis 

Pat’s tendonitis occurred because lifting her arm caused a tendon to pinch. Examination showed that her latissimus dorsi muscle (the largest shoulder muscle) was contracted and overly tight whenever she lifted her arm. This caused the joint to align incorrectly during motion, which resulted in that painful, uncomfortable pinch. 

Pat required fascia treatment in her low back area, which is where the latissimus muscle is anchored. There were also restrictions in the fascia of the left side of her rib cage and her left biceps muscle. In addition to fascia release therapy, she also received a specific massage therapy to coincide with her low back treatment. After a few weeks of these interventions, she was able to raise her left arm as high as the right, with comfort and ease. Bursitis Larry could not reach behind himself because of tension in the pectoral (chest) muscles and restriction of the fascia at the front of his shoulder joint. These issues were likely caused by a fall onto concrete two years prior, which caused shoulder pain for several weeks. The resulting muscular imbalance eventually led to inflammation and pain in a fluid-filled cushion of tissue called a bursa. This intensified pain to the restricted motion of the shoulder. In addition to treating Larry’s pectoral muscles and right shoulder joint, fascia restriction in his thoracic spine (mid-back) was also released. As we continued with treatment, he regained a full range-of-motion, without pain. However, I warned him to stop reaching behind from the front seat of his car into the back to grab his briefcase. That position is unnatural and stressful to the shoulder. Thus causing a repetitive re-injury each time he performed this movement. 

Rotator Cuff 

For Sue, her shoulder movements were unstable due to uneven tension and weakness of muscles around her shoulder blade. Sue’s pain built gradually over several months, rather than making a sudden appearance. The instability and awkwardness in her shoulder movements caused an incremental degeneration which, in turn, led to her rotator cuff tear. Sue’s primary issue was in the serratus anterior muscle underneath her shoulder blade. She also had restricted fascia at the base of her neck and down her triceps. In addition to treatment with fascia release therapy, Sue learned to perform specific shoulder stretches and exercises to speed her healing and prevent re-injury. After this treatment was complete, Sue could drink her morning coffee and drive without complaint. She still had to avoid strenuous lifting due to the rotator cuff tear, but she had no difficulties accomplishing her normal daily activities. 

Solving the Problems 

The solutions to these three different problems share one commonality—the need to restore muscular balance and stability to the shoulder. By using specific therapies to release fascia restrictions, stress was removed from the irritated connective tissue, allowing it to heal. This kind of fascia release for muscles of the shoulder often relieves pain even when there is a minor tear or other injury. In the cases of Pat, Larry and Sue, all three found significant relief and the ability to return to their daily routines. 

The Common Thread 

No two shoulder issues are exactly the same. However, almost all these conditions can be improved by restoring muscular balance and stability to the joint. There are many important facets to a successful shoulder treatment plan, such as stretches and strength exercises. The treatment that I usually find most critical is fascia therapy, because restrictions in the fascia are often the main cause of muscle weakness, tension. Or imbalance. When fascia therapy is combined with other treatment methods to restore muscular balance and control of the shoulder joint, many types of shoulder pain can be minimized or relieved entirely. This is even true when shoulder surgery has failed to resolve shoulder pain, or has created new pain due to scar tissue.  

Eric Winder, D.C., uses gentle manual therapy and rehab techniques to help patients with a wide range of pain and injury problems. Dr. Winder has offices in Sarasota and Osprey. For more information, call 941-957-8390 or visit https://gentlebay.com/