Beyond Shoulder Pain: Why Fixing the Root Cause Matters

When shoulder pain shows up, it can make simple things like reaching into a cupboard, putting on a coat, or lifting a bag feel frustrating and exhausting. Many people assume the problem is only in the sore spot, but often there’s more going on beneath the surface. 

Pain vs. Problem: What’s Really Going On?

When someone has shoulder pain, doctors and therapists often start by figuring out which tissues are irritated. There are so many types of tissues that make up the human body, like a tendon, bursa, or muscle and depending on what is giving you the problem can affect your treatment plan. Think of it like this:

If ten people start a “couch to 5K” running program, they might all end up with different injuries including but not limited to Achilles pain, plantar fasciitis, knee pain, hip pain, or low back pain. Those are the painful spots. But the underlying problem might be the same, such as feet that roll in too much (overpronation) or weak hip muscles that don’t control the leg well.

The same idea applies to the shoulder. Many people with shoulder pain share a common functional problem called scapular dyskinesis, which simply means the shoulder blade (scapula) isn’t moving the way it should.

Research has shown that abnormal shoulder blade movement is strongly linked to shoulder impingement and rotator cuff problems over time. When the shoulder blade doesn’t move well, the soft tissues in the shoulder, like the rotator cuff, bursa, and labrum can get pinched or overloaded.

What Is Scapular Dyskinesis?

Your shoulder blade is like a moving foundation for your shoulder joint. It should glide smoothly along your ribcage as you reach, lift, and move your arm. Scapular dyskinesis means that foundation isn’t doing its job well.

You might not feel pain in the shoulder blade itself, but it can quietly set the stage for:

• Shoulder impingement
• Rotator cuff irritation or tears
• Biceps tendon pain
• General “pinching” or catching with overhead movement

Common signs your shoulder blade may not be moving well include:

• One shoulder blade looking more “winged” or sticking out
• One side sitting higher or farther from the spine
• Feeling weaker or less coordinated when lifting overhead

These changes are often due to tight muscles in the front of the shoulder and weaker, underused muscles in the back that are supposed to stabilize the shoulder blade.

How We Look for the Root Cause

Most people don’t walk into our office saying, “I think I have scapular dyskinesis.” They say things like, “My shoulder hurts when I reach,” or “I can’t throw like I used to.”

At Buffalo Chiropractic + Physical Therapy, we look beyond the painful spot by:

• Watching how you move: We look at your posture and how your shoulder blades move when you lift or lower your arms.
• Checking strength and flexibility: We test the muscles that support your shoulder blade, neck, and upper back.
• Looking at the whole chain: Sometimes the neck, mid-back, or even your core can affect how the shoulder moves.

This kind of assessment helps us find the functional problem behind the pain, not just the irritated tissue.

Treatment: More Than Just “Resting” the Shoulder

Rest alone rarely fixes the real issue. Our goal is to restore healthy movement and strength so your shoulder can handle everyday life and the activities you love without flaring up again.

At BC + PT, treatment for shoulder blade related problems may include:

• Hands-on care: Gentle soft tissue work and joint mobilization to reduce tightness and improve movement around the shoulder and upper back.
• Targeted exercises: We focus on the muscles that stabilize the shoulder blade, such as the middle and lower trapezius and the serratus anterior. These muscles help keep the shoulder blade in the right position as you move.
• Posture and daily habit coaching: Simple changes such as how you sit at a desk, reach overhead, or carry bags can make a big difference over time.

Some of the types of exercises we often use (with proper instruction and progression) include:

• Movements that train the shoulder blade to move smoothly and stay stable as the arm lifts
• Gentle rows and pulling exercises to wake up the muscles between the shoulder blades
• Stretching for tight chest and neck muscles that pull the shoulders forward

The exact plan is always personalized to your body, your pain level, and your goals, and working with the same physical therapist every single session so you develop a true working relationship with them is one of the key factors to help make sure that you are staying the course of your healing journey.

How Buffalo Chiropractic + Physical Therapy Can Help

Quick fixes like braces, taping, or just “popping” a joint might feel good for a moment, but they don’t retrain how your shoulder moves. Long-term change happens when you start to move in a healthier way, you can build and strengthen the right muscles, and you avoid bad habits. This is all very daunting, and we're sure you are wondering, “how am I supposed to figure all of that out by myself?” 

Luckily, you don’t. At Buffalo Chiropractic + Physical Therapy, we take the time to explain what’s going on in clear, simple language. We connect your short-term goals to the long-term changes we’re building in how your shoulder and shoulder blade work together.

We know it can be frustrating to deal with ongoing shoulder pain. Having a team of chiropractors and physical therapists behind you every step of the way can be a big difference in your healing journey. Shoulder pain is common, but living with it doesn’t have to be your “new normal.” At BC + PT, we:

• Look beyond the painful spot to find the real cause
• Utilize physical therapy and chiropractic care to restore healthy movement
• Teach you practical exercises and habits you can use at home
• Support you through recovery so you can get back to work, sports, and daily life with confidence

If you’re dealing with shoulder pain, pinching, or weakness, especially with reaching or overhead activities, our team can help you figure out what’s really going on and create a plan that fits your life.

Call Buffalo Chiropractic + Physical Therapy at (716) 892-8811 to schedule an appointment at one of our multiple Buffalo locations and start moving, healing, and feeling better.

References

1. Neer CS. Impingement lesions. Clin Orthop Relat Res. 1983.
2. Kibler WB, Ludewig PM, McClure PW, et al. Scapular dyskinesis and its relation to shoulder pain. Br J Sports Med. 2013.
3. American Academy of Orthopaedic Surgeons. “Shoulder Impingement/Rotator Cuff Tendinitis.” AAOS
4. Cleveland Clinic. “Shoulder Pain.” Cleveland Clinic