SHOULDER PAIN: CAUSES AND EFFECTIVE EXERCISES

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How to Understand Your Shoulder Pain Better and Get Rid of It Permanently

You suffer from shoulder pains and have been trying to get rid of them for a long time? Are you longing to sleep peacefully again, to be able to cope with everyday life without help and to no longer suffer pain during physical activities? This does not have to remain a hopeless desire!

In this article, we will give you the necessary knowledge and show you exercises that will help you relieve your pain permanently — without any surgery or medication.

Step by step, you will learn how your shoulder is structured and what functions the individual areas have. This shall help you understand the most common symptoms of shoulder pain and where the real causes for them lie. To teach you how to help yourself, we will introduce you to our treatment approach and present you some useful exercises. Afterwards, you will be able to free yourself from pain — all on your own accord.

The shoulder is designed for full mobility. Theoretically, it enables you to touch virtually every point of your back or to reach high above your head with your hands.

In practice, things are often different. Because the greatest strength of your shoulder is also its most obvious weakness: its delicate construction makes it susceptible to hellish pain and mobile limitations of all kinds. However, this can be averted.

It does not matter whether you have already received a medical diagnosis or not. Impingement syndrome? Calcific tendinitis? Frozen shoulder? Or even osteoarthritis? That makes no difference. Since we believe most shoulder pain has an identical cause, treatment always starts at the same place. So you are welcome to join us on a journey of discovery through your shoulder. Some surprises await you!

Roland Liebscher-Bracht

Roland Liebscher-Bracht

Germany's best-known pain specialist and author of several bestselling self-help books on the treatment of pain conditions.

 
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Roland Liebscher-Bracht is Germany's best-known pain specialist and author of several bestselling books on pain treatment. Together with his wife, Dr. med. Petra Bracht, he has developed a revolutionary method to treat pain conditions. With the help of the so-called "osteopressure", where you press specific points on your body, and special stretching exercises, pain can be stopped entirely without medication or surgical intervention. This pain treatment allows you to alleviate pain by yourself. Find out how exactly this works in this article or our numerous YouTube videos.

Roland Liebscher-Bracht

Germany's best-known pain specialist and author of several bestselling books on self-help against pain.

 
Read more

Roland Liebscher-Bracht is Germany's best-known pain specialist and author of several bestselling books on pain treatment. Together with his wife, the physician Dr. Petra Bracht, he has developed a revolutionary new form of pain treatment: With the so-called "Osteopressur", in which certain points on your body are pressed, and special stretching exercises, pain can be stopped completely without medication or surgical intervention. It is particularly important that this pain treatment gives you the opportunity to help yourself against your pain in a self-determined way. You can find out exactly how this works in this article and in the numerous YouTube videos.

1. Structure and Function of the Shoulder


What are the most prominent features of the lightweight construction that is your shoulder, designed for maximum flexibility? First and foremost, the fact that the entire shoulder area is stabilised almost exclusively by muscles. As the shoulder works largely independently of the rest of the bony skeleton, healthy muscles are essential for it. If the muscles are overstretched or “shortened”, your shoulder’s mobility will quickly deteriorate, which is a painful experience.

Unilateral and repetitive movements, and above all bad posture, are the main reasons for the progressive worsening of your shoulder. Considering that we spend more and more time sitting, the widespread incidence of shoulder problems cannot be surprising:

 📌 More than 25 percent of Germans suffer from shoulder problems requiring treatment at some point in their lives. 1)GEO WISSEN Gesundheit, Sonderheft “Muskeln, Knochen, Gelenke”, 2018; 5, S. 116 This is associated with a dramatic increase in shoulder operations in the last 30 years, especially for the treatment of the so-called impingement syndrome. 2)Beirer, M., Imhoff, A.B., Braun, S., Impingement-Syndrome der Schulter. In. Der Orthopäde; 2017, (46) 4, S. 373

The reason why monotonous movements can have such dramatic effects on your shoulder becomes clear when you take a closer look at the individual joints and muscles of your shoulder apparatus in the following section.

1.1 The Joints of Your Shoulder

Three joints characterise the construction of your shoulder:

  • The main joint is the central ball joint of your shoulder. It connects your humerus, where the biceps tendon is located, with the shoulder blade (scapula). The head of the humerus is embedded in a small socket in the shoulder blade.
  • The acromioclavicular joint is the connection between the collarbone (clavicle) and the bony outgrowth of the shoulder blade (acromion).
  • Contact with the rest of the skeleton is ensured by the sternoclavicular joint, which is formed by the clavicle and chest bone (sternum).

Within this system, the head of your humerus has a very wide range of motion. It is not deeply embedded in a bony socket, but can move back and forth in a small hollow at the side of the shoulder blade. This allows your arm maximum freedom of movement, but offers the joint head hardly any support. We will tell you below what consequences this can have..

The shoulder blade has no direct contact with the spine. There is also no firm connection to the ribs. Instead, it lies loosely on the rear part of the upper costal arches, separated from them by the muscular inner side. 3)GEO WISSEN Gesundheit, Sonderheft “Muskeln, Knochen, Gelenke”, 2018; 5, S. 114

The acromion is an extension located at the top of the shoulder blade. Numerous muscles and tendons are attached to it, allowing flexible movements of your arm in almost all directions. Unfortunately, in the vast majority of cases, they are also responsible for your shoulder pain.

An illustration of the shoulder joint.

© Alila-Medical-Media (bearbeitet) | shutterstock.com 

1.2 The Muscles of Your Shoulder

Your shoulder joints are almost exclusively stabilised and directed by muscles. With their help you can spread your arms or pull them close, rotate them outwards or turn them inwards. From various points on the shoulder blade, these muscles draw towards the main joint. There they spread into tendons that almost completely surround the joint head of the humerus. The entire joint is thus enclosed by a kind of “tendon cap” called the rotator cuff. In addition, the large pectoral muscle at the front, the delta muscle on the shoulder, the biceps with the biceps tendon in the upper arm and the trapezius muscle in the back provide the necessary support.

📌 Within the rotator cuff, the upper bone muscle (musculus supraspinatus) is of particular importance — particularly for your pain. Its tendon, the supraspinatus tendon, runs through the very narrow space between the humerus and the acromion. There is a bursa filled with fluid under the acromion. It serves as a displacement layer for the supraspinatus tendon in relation to the bone and is intended to prevent painful friction on the acromion..

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2. The Most Common Types of Shoulder Pain


As you know, the functionality of your shoulder depends directly on the health of the muscles surrounding it. You can deduce from this that most of the shoulder problems today can be traced back to muscular issues in the area of the rotator cuff. The three most common types of pains are as follows.

2.1 The Impingement Syndrome

No other phenomenon in the shoulder area results this often in a trip to the doctor’s or leads to the usage of painkillers as the impingement syndrome.

This syndrome surfaces at perhaps the weakest point of your shoulder: the narrow space between the acromion and the head of the humerus (subacromial space). If the glenohumeral joint is out of balance, the head of the joint pushes towards the acromion when you lift your arm or turn it to the side. All the structures in between are thus trapped. The tendon attachments of the supraspinatus tendon and the bursa can swell and become inflamed. The unpleasant consequence is severe pain, often spreading to the arm, wrist or neck. 4)Konrads, C., Reichel, T., Ultraschallbefunde bei Schulterschmerzen. In: MMW-Fortschritte der Medizin, 2015; (157) 18, S. 73

2.2 Calcific Tendonitis

Mostly between the age of 30 and 50, the symptoms of calcific tendonitis (tendinosis calcarea) become apparent. While the symptoms are similar to those of the impingement syndrome, conventional medicine assumes a different cause for this disorder.

What is certain is that calcifications form in the tissue of the shoulder tendons, about 80 % in the supraspinatus tendon. 5)Diehl, P., Schauwecker, J., Schmerzhafte Schulter — ist es Kalk? In: Orthopädie & Rheuma, 2015 (18) 4, S. 36 These sediments can lead to individually different complaints: sometimes the shoulder pain is mild or severe, sometimes continuous, but more often only under stress or exclusively at night. Phases of a complete lack of pain may also occur. 6)Diehl, P., Schauwecker, J., Schmerzhafte Schulter — ist es Kalk? In: Orthopädie & Rheuma, 2015 (18) 4, S. 36

Depending on where the calcium is located, the sliding ability of the tendon attachments suffers. In addition, the bursa under the acromion is often inflamed. Does this sound familiar to you? Of course! The overlaps with the impingement syndrome are obvious.

2.3 Tears in the Shoulder Tendons

Tendons of the rotator cuff can tear partially or completely. This is called a tendon rupture. The risk of a tendon rupture is particularly high with an advanced impingement syndrome. If the tendon is already brittle, it does not take much for a tendon to separate: incorrectly propping up an arm or lifting something heavy often suffices in causing the damage. Ruptures mostly affect the supraspinatus tendon, though sometimes even all four tendons of the cuff.

2.4 Frozen Shoulder

From a conventional point of view, not all shoulder issues are due to problems with the rotator cuff. The joint capsule can also be painfully altered. With the so-called frozen shoulder stiffness, also known as adhesive capsulitis, it is thickened, hardened and partially inflamed. This inflammation leads to a severe restriction of mobility of the affected shoulder and often forces the patient into a pain alleviating position. Even pulling a parking ticket or personal hygiene can become unsolvable tasks.

shoulder pain by frozen shoulder

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How does the condition develop? Research has not yet found a clear answer to this question. Codman’s findings on the Frozen Shoulder from 1934 therefore still seem to apply to many doctors: “Difficult to define, difficult to treat and difficult to explain from a pathological point of view”. 7)Buess, E., Frozen Shoulder: Diagnose, Verlauf und Optionen für die Therapie. In: Orthopädie & Rheuma, 2012; (15) 1, S. 20  It is only known that diabetes or an underfunction of the thyroid gland increase the risk — for reasons that are also yet unknown.

However, more interesting is that about 60 % of patients with an inflamed capsule also have impairments of the supraspinatus tendon 8)Buess, E., Frozen Shoulder: Diagnose, Verlauf und Optionen für die Therapie. In: Orthopädie & Rheuma, 2012; (15) 1, S. 21 and that “the inflammatory process usually starts from the rotator interval“. 9)Hertel, R., Die steife Schulter. In: der Orthopäde, 2000; (29) 10

The predicted course of shoulder stiffness is no cause for joy. The “disease” often heals by itself, but only very slowly: “The patient has to expect three phases, each lasting about three to twelve months”. 10)GEO WISSEN Gesundheit, Sonderheft “Muskeln, Knochen, Gelenke”, 2018; 5, S. 121

What are your options? Swallow painkillers and clench your teeth for a whole year? No way! You can find out how you can help yourself faster here in our exercise section.

2.5 Arthrosis of the Shoulder Joints

Shoulder arthrosis is less common and therefore less known than arthrosis of the knee and hip joints. However, as everywhere in the body, the joints of your shoulder girdle can also be affected by osteoarthritis. It most commonly occurs in the acromioclavicular joint.

It gets trickier with the so-called omarthrosis, the loss of cartilage in the main joint of the shoulder. Affected people usually complain of pain in the anterior, upper shoulder area, which occurs during a load, and often afterwards. Lying on the shoulder is particularly painful.

According to conventional wisdom, your arthritis pain is caused by damage to the structure itself — in other words, by the joint surfaces of the humerus and shoulder blade rubbing against each other. We are certain this is wrong. You can read here why we think so and what the real causes of your shoulder arthrosis are.

2.6 Fractures and Traumas

For a certain group of shoulder issues the causes are obvious. These are injuries to the bone or joint, which can always be traced back to a very specific event, usually an accident.

A fracture of the collarbone, for example, is a typical injury caused by falls while skiing or cycling. But collisions during physical exercises can also cause the head of your humerus to slip out of the socket on the shoulder blade. The result is a dislocated shoulder, which doctors call an acute shoulder dislocation. It is just as unpleasant when the acromioclavicular joint is disrupted. With this shoulder injury, the joint capsule is torn and ligaments close to the joint are sometimes severed.

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3. Causes of Shoulder Pain


The shoulder-neck area is the second most common region of the human body affected by chronic pain — and the trend is increasing. 11)Sohns, S., Schnieder, K., Licht, G., von Piekartz, H., Manuelle Triggerpunkttherapie bei Schulterschmerzen. In: Manuelle Medizin, 2017; (55), 3, S. 160 What is the reason for this? From our point of view, it is mainly due to strained muscles and fasciae around your shoulder joints. We will now tell you what exactly we mean by this and what causes the muscular-fascial imbalance in most cases.

3.1 Muscular-Fascial Tension: The Liebscher & Bracht Explanatory Model

Nowadays, most jobs require us to assume a sitting position over a longer period of time. We frequently remain in this position during our leisure activities as well: in front of the computer or TV, during meals or in the car. Our musculoskeletal system is therefore subject to one-sided strain, which is fundamentally different from what we experience when standing, walking or squatting. The problem: our body is not made for this kind of behaviour!

For example, if you have to spend several hours at an office desk, you may often be sitting bent forward: your thoracic spine bends backwards, your head is overstretched and your shoulders are constantly moving forward or rotating inwards. Doctors speak of a hyperkyphotic posture, which can be the cause of persistent shoulder-neck pain or worse, the impingement syndrome. 12)Frössler, C., Sitzen und Schulter-Nacken-Schmerzen. In: Manuelle Medizin, 2007; (45) 5, S. 331 Several studies prove the connection between a lax sitting position and limited mobility of the shoulder joint. 13)Frössler, C., Sitzen und Schulter-Nacken-Schmerzen. In: Manuelle Medizin, 2007; (45) 5, S. 333

Impingement Due to “Shortened” Muscles

Let us take a closer look at the development of the impingement syndrome from this perspective. To keep the head of your humerus centered in the socket, all the muscles involved in your shoulder have to work together in a coordinated manner. If they do not, conflicts between soft tissues and the bone quickly arise. This happens especially when you sit at your desk bent forward all day.

This means that you use only a fraction of your shoulder’s movement potential. Did you know that on average, we use less than ten percent of all joint angles with our shoulder that would naturally be possible?

📌 This has consequences: because the muscles that are supposed to straighten your cervical spine, chest and shoulder gradually recede and the associated fascia become matted. These “shortenings” harden over time if you do not provide the necessary compensation. At some point, “shortened” muscles can no longer center your humeral head in the joint. The bone “migrates” further and further upwards and can press tendon attachments and bursae against the acromion. It simply becomes too narrow in your shoulder!

Signal Pain Instead of Structural Pain

Sometimes painful bone outgrowths, so-called osteophytes, form between the humeral head and the acromion. From our point of view, however, your shoulder pain is in most cases not a structural pain. In other words, what hurts has usually nothing to do with damage or inflammation. Your shoulder is not broken, but your body protects it from further damage by causing pain. We at Liebscher & Bracht therefore speak of signal pain.

So-called interstitial receptors are located in the periosteum, which register impending damage and transmit the threat to the structure to the brain. Here the periaqueductal grey (PAG) in the midbrain is responsible for the perception of pain. If your shoulder joints are threatened by muscular-fascial tensions, the periaqueductal grey projects pain into your shoulder girdle and in this way makes you aware of the threat to the structure.

3.2 Conventional Theories of Shoulder Pain

Muscles and fasciae are elementary for a healthy shoulder — conventional approaches have also recognised this. Nevertheless, they cannot adequately explain many of the shoulder pains that occur today. As per usual, age and “natural” wear and tear are thus used as the basis for explanation.

Take their standard answer to what causes the impingement syndrome: once a person has passed the age of five decades, wear and tear of the rotator cuff occurs of its own accord. Due to a reduced metabolism in old age, the tendons are less able to regenerate. For example, the supraspinatus tendon loses its robustness and elasticity, frays and can tear under everyday stress.

For the frozen shoulder, too, age-related wear and tear is one of the most popular explanatory theories, in addition to the metabolic disorders mentioned above. Some researchers even construct their own “frozen shoulder personality”. This personality is characterised by increased anxiety, inner tension, insecurity and a feeling of being overtaxed. From our point of view, cause and effect are mixed up here. Do you not think it is much more likely that fear and mistrust are the result of chronic pain rather than its trigger?

In our experience, stiffness of the shoulder is the result of a process that begins insidiously. Over years and decades the affected person unknowingly causes his fasciae and muscles to shorten further and further. Thus, one-sided movements and muscular-fascial tension can initially lead to impingement. At some point, the tensions are so great that nothing works anymore. The metabolism slows down drastically, fasciae become matted and the inflamed capsule is your organism’s reaction to the wear and tear. However, this is not age-related but “learned”.

calcified shoulder

Things are very similar with the calcific tendinitis. It is true that larger calcium deposits can limit the sliding ability of the rotator cuff under the acromion 14)Diehl, P., Schauwecker, J., Schmerzhafte Schulter — ist es Kalk? In: Orthopädie & Rheuma, 2015 (18) 4, S. 38

However, in our view, it is always a consequence of degenerative processes in the shoulder, not the cause. If you move your shoulder too little, calcium can accumulate there — as a side effect of a muscular-fascial imbalance.

Every tenth German has calcium deposits in the shoulder area. Is it not astonishing that only a fraction of them actually complain about pain? Moreover, calcified shoulders can occur as early as the third decade of life. 15)Diehl, P., Schauwecker, J., Schmerzhafte Schulter — ist es Kalk? In: Orthopädie & Rheuma, 2015 (18) 4, S. 36 So there is some evidence that neither calcification nor age-related wear and tear are the cause of your shoulder pain.

In our opinion, the most serious error concerns the conventional view of shoulder arthrosis. Besides torn tendons and damage to the capsule and ligament apparatus, conventional approaches name the age of the patient as the decisive factor. At first this seems obvious. Numerous studies confirm that osteoarthritis occurs much more frequently among older people than among young people. So are cartilage loss and shoulder pain in old age really an inevitable fate?

Our answer is clearly no! If the muscular-fascial tension is compensated for by using as many joint angles as possible, the pressure on cartilage and joints can be reduced enormously. Then you have a good chance of living without shoulder pain and increased wear and tear of your shoulder joints even at an advanced age.

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4. Treatment of Shoulder Pain


How can you keep your shoulders as flexible as possible until old age? Basically, by preventing or reducing muscular-fascial tensions. In this chapter we will tell you how our treatment approach can help you on your way to freedom from pain. We also introduce you to conventional therapy methods and reveal their weaknesses.

📌 Why do older people tend to have shoulder pain or shoulder arthrosis? The answer is actually quite simple: The older a person gets, the more time they have to accumulate more and more over-tensions through one-sided movement patterns. At a certain point, the wear and tear on your cartilage is then too great. There is a risk of damage to the shoulder joint, to which your body reacts with alarming pain.

4.1 Reducing Tension in the Shoulder and Eliminating Pain: The Liebscher & Bracht Therapy

The great influence of muscles and fasciae on the health of your shoulders offers you a huge advantage: you can become your own therapist, since it is up to you how high your muscular and fascial tensions in the shoulder area are. If you compensate for one-sided movement patterns and use multiple joint angles, your shoulder will reward you with full mobility and permanent painlessness. Just try it out! To start our shoulder pain exercises, click here.

Our pain therapy starts at the root of your issues and does not only treat the symptoms. As you now know, there are many indications that there are disturbances in the muscular-fascial network behind many pains in the shoulder area. From our point of view, this is exactly where treatment has to start. That is why all three components of our concept — osteopressing, bottleneck stretching exercises and fascial roll massage — are aimed at normalising muscular-fascial tensin. Let us take a brief look at the three forms of treatment.

roland liebscher-bracht shows the osteopressur for shoulder pain

Osteopressure According to Liebscher & Bracht

Osteopressing according to Liebscher & Bracht has been specially developed to reduce muscular-fascial tensions and eliminate pain in an amazingly short time. To do this, osteopressing uses interstitial receptors, which you have already got to know in chapter 3.1. Liebscher & Bracht therapists press these receptors in the periosteum from outside. This causes them to reset certain brain programs that cause excessive muscle tension. The body reacts immediately: the excessive tension is significantly reduced, so that your shoulder pain and the immobility in your shoulder can also decrease noticeably.

Bottleneck Stretching Exercises

It is crucial for you to permanently eliminate the cause of your shoulder pain. You should therefore consistently create a balance for your one-sided movement patterns.

  • With our exercises, you make the muscles around the main joint of your shoulder so flexible that the head of the humerus can slip back into its intended position. Muscles and fasciae then find it increasingly easier to keep it in the socket. New space is created between the acromion and the head of the joint, and the impingement recedes. As a result, the tendons can regenerate — even if they are torn — and the bursitis heals. If tendons have already been affected by the incorrect strain, they can now recover and restructure themselves through the “healthy programming” of the muscles involved.
  • The more you relieve your shoulder in this way, the more flexible it becomes. The metabolism is stimulated and a possibly inflamed joint capsule can repair itself due to better blood circulation.
  • The calcified shoulder will also find it much harder to give you sleepless nights. Once you have reduced the tensions around your shoulder, your body can continue to break down the calcium. In many cases, your shoulder area will be completely free of sediments again at some point. And even if it will not be, you are almost certain to be rid of your pain anyway.
  • You can even get your shoulder arthrosis under control with our exercises. They help you reduce the tensile forces that press the joint surfaces in your shoulder together and thus also the abrasion of cartilage. With a lot of patience, the cartilage in your main joint can actually grow back. This may surprise you, as many doctors have the opposite view: “Gone is gone” is still the doctrine regarding destroyed joint cartilage. We see things differently.
Fascial Roll Massage Set

Foam Rolling

Foam rolling offers you that little bit extra for your individual pain treatment. With the help of foam rolls and balls, you can release tensions on the upper arm, shoulder and neck and move metabolic products that are no longer needed. These can then be processed more quickly. You actively stimulate repair processes by getting your metabolism moving. Important rebuilding work towards freedom from pain takes place more quickly.

4.2 Other Treatment Approaches for Shoulder Pain

As varied as the pains in your shoulder are, as numerous are the therapies applied. We will now tell you which treatment measures are most frequently recommended and what we think of them.

Medication for shoulder pain

Drugs: For severe shoulder pain, your doctor may prescribe medication. If, for example, the bursitis is massive, a calcium deposit is being emptied or the shoulder is completely “frozen”, the administration of non-steroidal anti-inflammatory drugs (NSAIDs) is considered the therapy of choice by many doctors. In the case of massive complaints, this can be supplemented by the intake of analgesics. These are pure painkillers which — unlike NSAIDs — have no anti-inflammatory effect.

Our aim here is not to demonise drugs in general. They can briefly relieve your shoulder pain to get you through the day, to let you find some rest at night or to enable you to do exercises. However, we want to make you aware that painkillers are not a permanent solution for your shoulder pain. On the one hand, they have numerous side effects that put additional strain on your body. On the other hand, they only temporarily soothe the symptoms, but they never get to the cause of your shoulder pain.

injection

Steroid injections: Injecting steroids can provide rapid relief for shoulder pain — usually faster than stretching or movement exercises. This is the conclusion of a British study involving 232 shoulder patients.

However, the study also shows that in the long term, in this specific case after three months, the effects of steroid treatment and exercise are the same. 16)Füeßl, H. S., Schulterschmerz: Bewegug wichtiger als Steroidinjektionen. In: MMW-Fortschritte der Medizin, 2010; (152) 48, S. 23

Shoulder pain can therefore be successfully treated without injections. With our exercises you save yourself the trip to the doctor and protect your organism from foreign substances.

Shockwave therapy

Shock wave therapy: Extracorporeal shock wave therapy (ESWL) is a procedure that has been used since the 1990s to treat calcified shoulders. High-energy shock waves are used to destroy the calcium deposit or to stimulate the blood circulation and metabolism in the diseased tissue. 17)Diehl, P., Schauwecker, J., Schmerzhafte Schulter — ist es Kalk? In: Orthopädie & Rheuma, 2015 (18) 4, S. 38 f. 

However, the exact mode of action of shock waves in orthopaedics has not yet been fully clarified. In addition, there is not yet sufficient scientific evidence of the effectiveness of shock waves for shoulder pain.

In addition, shock wave therapy sometimes has undesirable consequences. Many patients find the sounds of shock wave therapy unpleasant and the procedure itself painful. If high energy dosages are used, your shoulder must be given a local anaesthetic. In addition, redness, swelling and bruising can occur in the tissue exposed to the ultrasound.

So before you spend a lot of money and endanger your health, try our exercises. These have no side effects, are free of charge and in most cases can help you better.

Acupuncture

Acupuncture: What does acupuncture do for shoulder pain? This question cannot be clearly answered in view of study results. Some findings suggest that acupuncture is more effective for chronic shoulder pain than drugs, shock waves or physiotherapy. In the early stages of the impingement syndrome, a combination of training therapy and acupuncture seems to be able to improve shoulder function and reduce pain. 18)Stör, J., Stör, W., Die Studienlage zur Akupunkturwirkung bei Schulter-Arm-Syndrom (beispielsweise Frozen Shoulder, Periarthritis humeroscapularis. In: Deutsche Zeitschrift für Akupunktur, 2017; (60) 3, S. 20 f.

In other words, acupuncture will probably not harm your shoulder. However, whether or not this alone will get rid of your shoulder pain permanently is unclear..

4.3 Shoulder Operations: That Is Why They Are of No Use

Operations of the shoulder are often the end of an unsuccessful conservative therapy.

Surgery
  • If no improvement is in sight after three to six months, doctors usually recommend arthroscopic subacromial decompression in cases of impingement syndrome. In this procedure, parts of the acromion are smoothed with a milling machine and bone edges are cleared out. At the same time, the surgeon enlarges the sliding space between the humerus and the acromion during arthroscopy by removing the inflamed bursa.
  • The surgeon can also intervene surgically to stop the inflammation in the frozen shoulder. Patients are advised to do this especially if the complaints are very severe or last for an unusually long time. In this case, the surgeon detaches the stiffened capsule from the bone and makes a longitudinal incision. This arthroscopy is called capsulotomy.
  • If the calcium deposits are in your shoulder, they can be removed with a sharp spoon. Alternatively, the so-called needling can be used. Here the doctor tries to puncture the calcium deposit several times with a needle to add table salt to the deposit. At this point, we do not want to conceal from you the fact that the results of this procedure are controversial and that “there is no reliable evidence of its effectiveness”. 19)Diehl, P., Schauwecker, J., Schmerzhafte Schulter — ist es Kalk? In: Orthopädie & Rheuma, 2015 (18) 4, S. 39
  • Not a particularly pleasant prospect, is it? And not a risk-free undertaking to do so! Surgery — even the most modern procedures — can lead to complications and offer no guarantee that you will get rid of your pain permanently.

Not a particularly pleasant prospect, is it? And not a risk-free undertaking to do so! Surgery — even the most modern procedures — can lead to complications and offer no guarantee that you will get rid of your pain permanently.

📌 Surgery will relieve your symptoms for some time, but will not eliminate the cause of your shoulder pain, no matter what is done to your shoulder.

5. Effective Exercises Against Shoulder Pain: How to Free Your Shoulders


You want to get rid of your shoulder pain without having to rely on medication, doctors and expensive treatments? Then you should definitely try our exercises and foam rolling!

It does not matter whether your pains are only occasional or chronic, whether you have impingement syndrome, frozen shoulder, calcific tendinitis or shoulder arthrosis. In our experience, most shoulder pain can be traced back to one and the same cause, so our treatment can also be successful in all these cases.

The aim of every exercise is to normalise the tensions around your shoulder. Over time, your muscular-fascial network will be able to function smoothly again. In short, the chances increase that your shoulder will regain its unique mobility and pain, irritation or inflammation will soon be a thing of the past.

▶ In this video, pain specialist Roland Liebscher-Bracht shows you the two most effective exercises against impingement syndrome and a foam rolling technique.

The Exercises:

Exercise against shoulder pain 1

For the first exercise, first go to the quadruped position. Take your hands outwards and place them well above shoulder width. Find a position that allows you to bend down with your sternum. When you have found the angle at which it pulls the most, stay in this stretch for two to two and a half minutes. Try to keep increasing the strain during the exercise. Enjoy the feeling when your tissue rises and you get a taste of your freedom from pain.

Exercise loop

For the second exercise, sit down and grab an exercise loop or something similar.

Exercise against shoulder pain 2

Place your hands a little bit over shoulder width and put your feet upright again. Now it is all about inching very slowly with your buttocks to the front, alternating your legs to the left and right. Make sure that your arms are fully extended and that your chest remains completely open. Move further and further into the stretching.

When you reach a point where you cannot go any further, stop the movement. This way you give your tissue time to slowly expand. After a short moment you can try to stretch a little bit more.

Exercise against shoulder pain 3

A fascial roll massage with a mini foam ball can further reduce the tension in your shoulder area. To do this, lie on your back and place the ball exactly in the hollow under your collarbone.

Work your way deep into the tissue and look for the most painful area. With slow, intensive and spiral movements you roll around exactly this spot.

By the way, there is no time limit for this. You can repeat the fascial roll massage several times a day: in the office, in the evening in front of the TV or whenever you want to do something good for your shoulders in a natural way.

📌 Checklist for the Liebscher & Bracht Exercises

To make sure nothing goes wrong with our exercises, we have put together six important tips. They should help you to easily integrate the exercises into your everyday life and achieve optimal results.

Practice six days a week and do each exercise at least once a day

For each exercise you should invest two to two and a half minutes. If you are just starting to do the exercises or if the pain is still too much, you can also gradually increase the intensity..

Always follow your personal pain scale of one to ten. You will get the best results if you work on a scale of eight or nine for each stretch. Nine means you feel an intense pain, but you can still breathe calmly and do not have to tense up.

A pain that is still bearable is the most important point of reference for you. So do not be afraid of it: your body points out to you that you are counteracting the contractions in exactly the right place.

During the exercises, always stretch both shoulders, but determine your individual range of pain based on the affected shoulder.

Be patient — even if it is difficult. You may have promoted the shortening and tensioning of your shoulder muscles for years and decades. It may therefore take some time for your brain to store new movement programs. But if you stay on the ball and make the exercises your daily routine, you can gradually regain a life free of pain.

Woman does Stretching exercise for pain

Free EXERCISES TO RELIEVE your PAIN

Sign up now for our weekly advisory newsletter to receive the latest exercises to help with your pain. You can easily do all of them at home, too. The best thing: our newsletter is completely free!
 
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Free EXERCISES TO RELIEVE your PAIN

 
Woman does Stretching exercise for pain
Sign up now for our weekly advisory newsletter to receive the latest exercises to help with your pain. You can easily do all of them at home, too. The best thing: our newsletter is completely free!
 
To discover how you can immediately treat your pain, enter your email address below:
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Free EXERCISES TO RELIEVE your PAIN

Woman does Stretching exercise for pain
Sign up now for our weekly advisory newsletter to receive the latest exercises to help with your pain. You can easily do all of them at home, too. The best thing: our newsletter is completely free!
 
To discover how you can immediately treat your pain, enter your email address below:
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I agree to the privacy policy and to receive the newsletter.

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