Dr. Damien Answers ALL The Shoulder Questions!

Q: Why does my shoulder pop during certain movements?  Should I be concerned?

A: It depends.  If the popping is directly associated with pain or instability, it is worth seeking professional evaluation.  If you just have popping with no pain or instability, it is likely the result of harmless gas bubbles that form in the joint fluid due to pressure changes during movement.

Q: How is tightness in the pec muscles related to shoulder pain?

A: The pec major attaches to the humerus (upper arm bone) and when it is tight it can pull the head of the humerus (the part that makes up the arm side of the shoulder joint) forward in the joint, altering joint mechanics in ways that may cause pain.  The pec minor attaches to the coracoid process of the scapula (shoulder blade) this can pull the scapula forward when tight also altering mechanics at the shoulder in ways that may cause pain.

Q: What is the rotator cuff?

A: The rotator cuff is a group of four muscles—the supraspinatus, infraspinatus, teres minor, and subscapularis—responsible for maintaining centration of the humeral head in the glenoid fossa (essentially keeping the ball of the shoulder joint tracking smoothly in its socket).

Q: What is the shoulder labrum?

A: The labrum is a fibrocartilaginous ring that spans the rim of the glenoid fossa (socket of the shoulder joint).  This ring of tissue creates a suction effect on the head of the humerus (ball of the shoulder joint) helping to hold it in place during movement.

Q: How can an injury to my neck cause pain in my shoulder?

A: This can be related to a number of things, but the most common are some type of nerve irritation and muscle tension.  There are nerves from the neck that innervate the muscles and sensory receptors in the shoulder region.  If any of these nerves become entrapped or injured, this can cause shoulder pain.  Many muscles also connect the shoulders to the neck and an injury to the neck may create tension and pain in some of these muscles, which can result in shoulder pain as well. 

Q: Why does my shoulder hurt when I do shoulder press in the gym?

A: This can be a result of many factors, but the easy answer is that you are lacking mobility or strength in at least one key area (likely more) that is changing the mechanics of this movement and causing pain.  Finding the true source of your limitation would require a full evaluation by a qualified professional.

Q: What is an AC joint separation?

A: An AC joint separation is a sprain of the ligaments supporting the acromioclavicular joint (articulation between the collarbone and the shoulder blade) that causes the joint surfaces to “separate” from one another.  In higher grade injuries there is a visible deformity at the top of the shoulder where the clavicle (collarbone) and acromion of the scapula (shoulder blade) have separated from one another.

Q: How do I fix my rounded shoulder posture?

A: This posture is usually due to tightness in the pectoral muscles.  It also commonly goes along with weakness in the important scapulothoracic muscles of the upper back.  To improve the posture in this area you must improve the mobility of your pectoral muscles and strengthen the upper back muscles to better support your shoulders in an upright position.

Q: Why do I always feel so tight on the tops of my shoulders?

A: It is common for people to carry tension in this area.  This tension can be related to stress and/or extended time sitting particularly while working on the computer.  The best remedy is usually trying to incorporate more movement into your day, taking frequent breaks to stand and move around when possible.  Strengthening the muscles of your upper back can also be helpful as well as making sure that your office setup is as ergonomic as possible. 

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