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The muscles around the shoulder are called the rotator cuff and provide stability, strength and motion for the shoulder. The rotator cuff muscles are supraspinatus for abduction, infraspinatus for external rotation, teres minor for external rotation and subscapularis for internal rotation and extension of the arm. Other important muscles are the deltoids, teres major and latissimus dorsi.
Common causes of shoulder pain are working at a computer, painting, carpentry, hair dressing, tennis or physical training with repetative overhead motion.
A traditional acupuncturist would first establish what type of pain the shoulder injury falls under.
This will determine the type of treatment, needling technique, other methods of pain relief for example moxibustion, cupping or guasha. Qi or blood stagnation are two types of pain but in Chinese there are other categories that are called Bi syndrome. For more information on this go to pain relief.
Acupuncturist look at the body in relation to meridians or channels. Channels can also be viewed as muscle grouping and myofascial plane This is the connective tissue that is found between muscles and skin. Each channel follows this same myofascial plane and muscle grouping. This is a good guide for acupuncturists to follow for shoulder pain.
If there is difficulty abducting the arm this means there could be stagnation in the large intestine channel. Muscles that abduct are the deltoids and supraspinatus with help from the serratus anterior.
If there is difficulty adducting the arm then there could be stagnation in the lung channel. Muscles that adduct are the pectoralis major and latissmus dorsi with help from the teres major.
If there is difficulty twisting the arm behind the back this there could be stagnation in the small intestine channel. The muscles related to the small intestine channel are supraspinatus, infraspinatus and teres minor.
Pain in a channel does not mean there is a problem in the organ.
There are other channels that pass over the shoulders. The above examples are the most common.
Pain might travel down or up the channel or channels affected. Needles are place in the areas of pain and further down the channel to help the flow and movement of Qi.
This occurs when the gleno-humeral joint is inflamed. Often triggered sprains that impair the movement of the shoulder. Tightness in the muscles that surround the shoulder joint are restricted. Often the supscapularis, This is a muscle found behind the shoulder blade (scapular). It is most common in people age 40 or over. The shoulder will be painful and stiff. There are three stages freezing, frozen and thawing.
During the freezing stage it will be painful reaching for things and the shoulder will start it ache. In the frozen stage there is restricted movement with no less pain. The thawing stage is when the range of movement increases and the pain reduces. This can happen naturally after 6 to 12 months. If the pain is too unbearable or if the thawing period is slow to progress then acupuncture is a good option.
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