Nearly everyone has back shoulder blade pain problems occur some days in their lives. Many people believe it will not occur to them, that it only affects high performing athletes. However, as much as 14 million people visit the clinic each year due to shoulder blade pain problems, although many try to push through the pain- hoping it will go away- only to create larger problems slowly over time manifesting to pain that is unbearable.
The incidence of shoulder blade pain is caused by many reasons. Some are due to falls form tackles to misstep in walking and others may be of overuse such as golf swings or manual wheelchair use. This pain can inconvenient the weekend athlete, the office worker hunched over a computer, the home owner who may paint a wall.
The three general classifications of injury are:
MILD—At this stage, the doctor may recommend a home-based exercise program that includes corrective exercise and specific stretches. Keep in mind, you are still injured and re-injury is very common. Do not rush the body’s healing.
MODERATE—At this stage, passive and light active range-of-motion exercises may be advised to prevent a frozen shoulder. Protective rest of the joint, as well as modalities to control pain, will be recommended.
SEVERE—At this stage, rest, ice and heat applications and range of motion exercises are often recommended. Pain-management options such as medications or possible injections can be discussed.
TYPES OF INJURIES
Knowing the cause of an injury is critical in developing a comprehensive rehabilitation program. Some injuries are the result of a sudden impact; others are the result of chronic misuse, overuse and abuse of the body or body parts. Generally speaking, there are two types of injury, macro trauma and micro trauma.
Macro trauma is an injury due to a specific event. The time, place and mechanism of injury are usually quite clear. The single event results in a previously normal/healthy structure becoming suddenly and distinctly abnormal after the event (e.g., shoulder separation).
Micro traumas are chronic, repetitive injuries. These injuries actually arise from misalignments and poor body mechanics combined with repetitive insults to the area. Chronic conditions, unlike acute injuries, must be managed and cannot be quickly resolved.
• Maintain proper posture.
• Motion is lotion—gently move your shoulder/arm several times each day.
• Avoid chills to the neck and shoulder area. Keep the joint area warm—warm joints are less easily injured and also respond better to movement than cold and stiff joints. Dressing in layers may be helpful.
• When sleeping on your side, rest the affected arm on top of a pillow for support.
• Avoid restrictive accessories that place pressure on the shoulder area (e.g., backpacks or heavy purses).
The rehabilitation goals for back shoulder blade pain occur in three stages: acute, recovery and function
Phase 1: Acute Stage
The acute stage focuses on preventing further harm, decreasing the signs and symptoms of injury, and hastening the healing process. A trained therapist should oversee this phase of rehabilitation.
The goals of Phase 1 are to:
• Manage pain
• Maintain range of motion
• Maintain neuromuscular control
• Prevent muscle atrophy.
The criteria for advancement to phase 2 are:
• Pain control
• Healing tissue
• Near-normal range of motion
• Tolerance for strength training.
Phase 2: Recovery Phase for back shoulder blade pain
This phase can be done with an adaptive fitness personal trainer or by yourself—as long as you/he/she stays within the scope of practice and is following the protocols set forth by the medical professional. At this stage, many people re-injure themselves, so be careful.
The goals of Phase 2 are to:
• Prevent further injury and pain
• Regain upper body strength and muscular balance and stability
• Foster shoulder flexibility
• Improve neuromuscular control and coordination
• Be evaluated for progression to next level.
The criteria for advancement to phase 3 are:
• No pain
• Complete tissue healing
• Almost complete range of motion
• Near-normal strength when compared to the uninvolved side (approximately 75 to 80 percent).
Phase 3: Function Phase for back shoulder blade pain
This phase can be done with an adaptive fitness personal trainer or by yourself to decrease back shoulder blade pain—as long as you/he/she stays within the scope of practice and is following the protocols set forth by the medical professional. Once you’ve re-gained full functional recovery, evaluate the circumstances that may have caused your condition and adapt your lifestyle and behaviors. By being sensible, following your therapist’s suggestions and participating in the exercises included in this book, you reduce your chances of re-injuring yourself.
The goals of Phase 3 are to:
• Learn the importance of proper training techniques
• Learn how to exercise the stabilizing muscles and learn proper posture and lifestyle changes to prevent future injury
• Increase muscular strength and endurance in preparation for work or sports demands
• Improve multi-plane range of motion
• Institute sport-specific drills and functional activities of daily living
• Be evaluated to see if you are ready to re-engage in a fully active lifestyle.
The criteria for knowing you’ve reached “full functional recovery” are:
• Zero pain
• Full and complete pain-free range of motion/flexibility
• Strength equal to the uninvolved side
• Normal body mechanics.
It is difficult to move a small object.
It hurts to reach for a high shelf
You hear a shoulder ‘pop’ after throwing something like a ball or pillow.
It is discomforting to reach to your back pocket to grab your wallet.
Many people who see the doctor for shoulder blade problems are affected by injuries to soft tissue surrounding the shoulder area. The goal of this website is to provide knowledge about possible shoulder problems and provide suggestions for preventions. This is not a substitute for medical care but rather to identify a small shoulder issue and suggest corrective exercise that can improve your abilities and decrease back shoulder blade pain.