The shoulder is complex. Or, rather, the shoulder is a complex. That means it is a collection of joints and structures, all of which need to be playing nicely with each other to allow the full range of motion this important area needs.
Problems in the shoulder area can be due to structural issues, such as rotator cuff dysfunction, wear and tear in the glenohumeral (shoulder joint proper) or acromioclavicular (the joint between the collar bone and top of the shoulder blade) joints; or functional issues, such as the shoulder blade not moving freely due to restricted ribs. It may also be due to referred pain from the neck or ribs; or (more rarely) from the viscera or internal organs. Irritated nerves in the neck can also give rise to shoulder and arm pain.
An osteopathic assessment of the shoulder should include careful and thorough examination of the shoulder complex itself, as well as the hand, wrist and elbow below, and the ribs, thoracic (mid-back) and cervical (neck) spine and jaw above.
Often the problem will be in one of the above areas, but may be predisposed towards or maintained by other factors in these regions.
For more information on the shoulder, check our series of blog posts here.