The normally functioning shoulder is a marvel of motion and integration of muscular activity. When a person considers the shoulder, she/he usually thinks of it as a relatively simple joint comprising the upper arm bone joining the shoulder socket; in reality, the structure is very complex. Many factors must be considered when evaluating the shoulder as a functioning unit.

The shoulder socket is a part of the scapula (shoulder blade). In the front, the scapula attaches to the breastbone via the collarbone. In the back, the scapula is held against eh back chest wall by muscles; there is no direct joint attachment. As the arm goes through its range of motion, there is literally a symphony of muscular action taking place. As certain muscles contract to raise the arm, others relax at precisely the correct time to allow freedom of motion and smoothness of movement. There are over twenty muscles directly or indirectly involved in shoulder action, making very complex integration of muscle activity necessary. The shoulder socket is very shallow, requiring excellent organization of the muscles to maintain proper movement.

Nearly all shoulder problems correlate to some degree with improper muscle activity. Because of the very important role played by muscles in normal shoulder function, they should always be examined whenever there is a shoulder involvement. The muscles should be tested for strength and length, as well as for integration of activity with one another.

Muscles usually become weak or overstrong from some type of injury. Specific ligament, joint, or muscle damage is often observed after an injury; however, a muscular imbalance that results as a secondary problem of the injury may not be observed by the attending physician. If muscular imbalance is not treated, a shoulder will continue to manifest symptoms long after the injury has healed. It also leaves an imbalance present for easy recurrence of problems or constant strain in the shoulder.

Common Shoulder Problems

Slipped Bicipital Tendon

A tendon is the fibrous band that attaches a muscle to bone. The biceps muscle - the large muscle in the front of your arm - attaches by way of a tendon to the scapula. This tendon lies in a groove; it can slip out of that groove as a result of injury that usually occurs because of a sudden jar while the biceps brachii muscle is contracted. A typical example is a workman carrying one end of a plank when his helper accidentally drops the other end, causing a severe jarring to his arm. Usually, treatment for this problem consists of replacing the tendon in the groove and then immobilizing the shoulder to aid the healing process.

Acromioclavicular Injury

The joint between the collarbone and the shoulder blade is often injured, especially in athletic endeavors. This injury is frequently treated with manipulation of the joint, designed to avoid any strain to the already injured ligaments. Sometimes immobilization is needed after treatment; if the ligament injury is extremely severe, surgery may be indicated.

Ligament Injury

Trauma to the shoulder often causes ligament injury. Ligaments are the fibrous bands holding bone to bone; they are components of almost all joints. Here again, immobilization is often needed for healing to take place. Whenever ligaments, tendons, or bones are injured, specific nutritional supplementation to aid the healing process may be indicated.


Dislocation, often resulting from severe injury, means that the arm portion of the shoulder joint has come completely out of the socket. Some individuals with improper muscle and ligament function can have a shoulder that slips out of place with certain motions when no injury is involved. This condition can frequently be corrected by an applied kinesiologist who examines the muscular balance and integration of muscle activity, and then makes the indicated corrections.

Frozen Shoulder

Inability to raise the arm above a certain point is a relatively common shoulder involvement. This is often attributed to factors such as ligament inflammation, arthritis, or bursitis; however, it is most commonly the result of improper muscle function. As mentioned earlier, there is a symphony of muscular activity in every shoulder motion. Sometimes the muscles attempting to lift the arm are incapable of doing so because the muscles acting in the opposite direction fail to relax at eh appropriate time. Activity of certain muscles is necessary in the process of lifting the arm to keep the socket from "jamming," which impedes arm elevation. Sometimes there may be complete correction of a "frozen shoulder" in a matter of minutes after an applied kinesiology examination and treatment - even if the arm has not risen above a certain point for years. Determining muscular coordination and strength is necessary for the successful treatment of this condition.

Arthritis and Bursitis

These terms refer respectively to inflammation of the joint and inflammation of the bursa (the lubrication membrane of the joint). Arthritis or bursitis is often secondary in nature to another, primary problem. Inflammation develops as a result of some irritating factor. A shoulder not moving in a synchronous manner becomes very irritated, and inflammatory processes develop. Synchronous movement of the shoulder joint depends absolutely on harmonious activity of all the muscles involved in shoulder activity. When the diagnosis of arthritis or bursitis is made, anti-inflammatory drugs are often given in tablet form or by injection directly into the shoulder structure. The injections are usually steroid hormones. These medications often give relief, at least temporarily; however, they do nothing to remove the cause of the inflammation. Another approach is to remove the cause and allow the symptoms to subside by themselves, preventing the possible side effects of drugs. Whenever arthritis or bursitis is present in a shoulder, the muscular strength and coordination of all the muscles involved with shoulder activity must be examined.

Other Causes of Shoulder Problems

Listed above are some of the more common problems directly associated with the shoulder. There are many symptoms of shoulder involvement - such as pain or limitation of motion - when the primary problem is not in the shoulder at all. It could easily be in the neck, pelvis, feet, wrist, or internal organs. The remote problem could cause symptoms in the shoulder by structural stress, interference with normal nerve action to the shoulder, or by referred pain.

Whenever there is a problem with a shoulder, the total body should be examined. After the initial healing process has been completed, the shoulder should be re-examined for muscular strength and harmony. This helps prevent future problems that may associated with the muscle imbalance.