Shoulder pain causes in sports succumb to the general principle of overuse, which can occur voluntary or involuntary. I have already discussed this principle here. Most of the times accidents or unbalanced training regimes are the source of evil.
I will give you examples of certain motions and postures that, over time, will lead to tender or trigger point development in the muscles of the shoulder. This in turn causes shoulder pain. As those motions occur voluntary, they display chronic and voluntary overuse.
Additionally I will show you how an acute trauma /accident on the shoulder can create muscular problems which can worsen the pain of the accident itself and perpetuate it after the joint has “healed”. Those examples refer to involuntary overuse – I just assume no one gets involved in accidents voluntary –.
I want to begin with one of the most common shoulder pain causes. It is a result of voluntary overuse and an unbalanced training. The round shouldered position. The round shouldered position leaves most of the chest and shoulder muscles in a chronically shortened and the ones at the back of your shoulder in an elongated position.
Both conditions – permanent shortening or elongation - are known to be favoring factors for tender and trigger point development.
But how does one develop a round shouldered position and how do the chest and shoulder muscles get into this shortened or elongated position, respectively?
There are mainly two factors. The first one is too much work stress on those muscles while the second refers to postural/positional stress. Actually, there is a third factor which is the abstinence of exercises that counteract on the first two factors.
Excess work stress depicts the scenario where you train the chest and shoulder muscles too much. When a muscle gets trained very often, it tends to tighten up. This is especially the case if you do not do any exercises that would prevent it from doing so or weaken this tendency. Such things might be relaxation, stretching or mobility exercises for the joint and its corresponding muscles.
With too much tension in them, those muscles pull the whole shoulder system forwards and a little downwards – by pulling on the collarbone and the humerus/bone of the upper arm –.
Additionally lots of the chest and front of shoulder muscles rotate the shoulder inwards. Thus, when they tighten up they will finish the work for the round shouldered position.
Then let some time pass, do not counteract and keep training and those tight muscles will create tender and trigger points, which in turn will give you pain in your shoulder. So, excess work stress really is one of the most common shoulder pain causes.
Here are some examples of movements where you use your chest and front of shoulder muscles a lot.
Postural stress is also one of the main shoulder pain causes and plays an important role in sports. Here it is not too much active stress trough muscular contraction that is causing the round shouldered position but postures/positions themselves.
Two brilliant examples are table tennis and rock climbing. In both sports you spend quite some time in a round shouldered position without using the chest and front of shoulder muscles too much.
In rock climbing, very often you are hanging in a more or less overhanging terrain on your “long” arm. Especially when planning the next moves this is necessary to avoid too much muscular exhaustion of your arms and your upper back.
Over time and when climbing a lot, this leads to a shortening of the chest and front of shoulder muscles. Additionally one main workhorse in climbing – the latissimus/the big muscle that gives you that V shaped back – also rotates your shoulder inwardly. As this muscles works a lot in climbing, you foster the round shouldered position even more.
In table tennis, the players mostly are in a bend over and crouched position with the arms held in front of their bodies. Again, this is a situation where the chest and front of shoulder muscles are in a shortened position. The effects are the same like in rock climbing. Over time, and without counteractions, the body gets used to the position and maintains it in daily life – even if it is in a less dramatic way –.
You might have already read that muscles do not like to be in shortened positions for long times. If they are, they are prone to develop tender and trigger points which in turn initiate pain. So the trigger points are secondary shoulder pain causes as they develop as a result of muscular “abuse”.
By now you know how the round shouldered position affects the front side of your upper torso. The next step is to explain to you how it affects the back side of your shoulders and its corresponding muscles.
I guess you can imagine that excessive tension in the front of your shoulder and the resulting pull on the muscles, connective tissue, on the collarbone and humerus affects the position of the shoulder blade and its muscles.
With a round shouldered position, the shoulder blade rotates outwardly – that is the opposite motion as if you were pulling your shoulder blades together and thus inwardly – and the upper arm inwardly – e.g. right arm would turn counterclockwise –.
Then you also should know that some muscles on the back of your shoulder blade rotate the shoulder outwardly and are attached to the upper arm. That means by rotating the upper arm inwardly they get stretched/elongated as this is the opposite movement they naturally intend to do.
You see that the round shouldered position also creates mechanical stress on these muscles and leaves them in an elongated position as there is a constant pull on them. This pull and the resulting stretch have the same effects as the shortened position of muscles or too much work stress. They create trigger and tender points.
Now you know how a round shouldered position, which is common in sports, affects both sides of the shoulder - the back and the front – in a negative way and can be the cause of shoulder pain.
Almost everyone experienced it and it is also clear to everyone that something hitting your shoulder hard can give you shoulder pain. Let us assume you ride your bike and fall which may lead to the unfortunate circumstance of smashing your shoulder and tearing apart some of its stabilizing ligaments.
It will hurt, for sure, and you will get medical care. The doctors fix the ligaments with surgery or they may heal themselves when put in a stabilizing bandage. After a few months your ligaments are ok again. The initial pain went away, but what is left is a different pain. Somehow you cannot move your shoulder through its full range of motion and some of your movements hurt.
Well, the initial pain might be gone and the damaged structures healed. But what may be left are strained muscles that no one took care of. When you fall on your shoulder very hard, and you did as you tore some ligaments, your muscles worked extremely hard during the impact to stabilize your shoulder as much as possible to prevent it from falling apart totally.
This heavy muscular work and the impact of the muscle on the ground itself can cause trigger points. The damage of the passive structures may have already healed but the muscles can be left with almost the same tension they had when they wanted to protect your joint. If that is the case, the shoulder pain causes changed from brutal external force with subsequent joint damage to pain which is from muscular origin.
Causes in Sports