A Chiropractor can do a detailed analysis on the shoulder and do the patient a great service. The humerus is the upper arm bone, and makes up most of the shoulder joint. The humerus can misalign (subluxate) a number of different ways:
Anterior- If this is the case, the Pectoralis Major wouid be spasmed. Along with working on this muscle, the Chiropractor can adjust the humerus back to its position. We personally use a drop piece to perform this. It does not hurt the patient at all. But there are numerous ways a Chiropractor can do it.
Anterior, Internal Rotation- From the above, add the internal rotation. This would most likely indicate the Subscapularis muscle is spasmed (along with the Pectoralis Major). The Subscapularis is a Rotator Cuff Muscle (the biggest Rotator Cuff muscle). One of the ways a patient can confirm this by themselves is to see if there is pain in the throwing motion.
The reason there is pain when you throw is simple. When you throw, you are putting your upper arm into internal rotation. Well, it already is in internal rotation if you have the above subluxation pattern. So you are putting the upper arm into MORE of an internal rotation than it already is. Well, that is going to hurt. Plus, once the humerus internally rotates, it has to also go anterior.
Anterior, Internal Rotation, Superior- From the above cases, now add superior. It also subluxated superior because the Supraspinatus is too tight. This is a Rotator Cuff muscle. We use a drop piece for this adjustment as well. But now we have to add Muscle Work to address this muscle (because our drop piece would do nothing to help this muscle). We use Active-Release muscle technique to calm this muscle down back to its natural position (so not superior). There are many Chiropractic methods to address this, but we are sharing how we do it.
The same holds true for this as well. The patient would have pain when he or she does the throwing motion, and for the same reason listed above.
Posterior- The humerus would subluxate posterior. We usually find a spasm of the Posterior Deltoid muscle (and of course the humerus was pushed back in the posterior position). We use a drop piece for all our shoulder adjustments, because we find it provides the least amount of discomfort. This is what we found in our office, but there are many different techniques to accomplish this.
Posterior, External Rotation- Once a humerus rotates externally, it has to also subluxate posterior. When it rotates externally, we also check the Infraspinatus and Teres Minor muscles. These Rotator Cuff muscles externally rotate the humerus. We find they are doing too good of a job (because the humerus is externally rotated), and should be relaxed to the humerus can go back to it's natural position. Along with the muscle work that goes with this, we use a drop piece to correct these this subluxation pattern. There are many Chiropractic Techniques for this, we are just sharing ours
The patient can check to see if they have this subluxation pattern. Does it hurt to bring your arm back to throw something? If it does, then the humerus could already be externally rotated. When you bring your arm back to throw, you are externally rotating it even further. I can see why that would cause pain.
Posterior, External Rotation, Superior- This is the same subluxation pattern as above. You can even check if you have it by the last paragraph above. Now add a superior component to it. The Supraspinatus is too spasmed, making the humerus subluxate superiorly. We perform the Active-Release technique to relax this muscle, along with the drop piece to correct the posterior and external subluxation pattern. There are many Chiropractic techniques to do this, we just choose this method.
You must also address between the shoulder blades. 100% of shoulder problems arise from between the shoulder blades. We don't adjust this bone, because it is suspended by muscle. So we just relax whatever muscle is causing its abnormal position from it's natural state. Most times we have to tell the patient what muscle to work on at home to help our adjustments. For instance, if the shoulder blade (scapula) is superior and lateral, the Pectoralis Minor is likely a contributor to the problem. If the shoulder blade is lateral, or you see "winging" of the shoulder blade, then the Serratus Anterior is likely a contributor to the problem (especially if push-ups, punching, or pushing an object away is an issue)
The Clavicle can subluxate inferior next to the sternum (chest bone) and can subluxate superior close to the A/C joint (this is actually 50% of this joint). This bone must be addressed as well
Bicep Brachii Muscle
Did you know 67% of the long head of this muscle goes attaches to the posterior labrum of the shoulder capsule. 33% of the long head of this muscle attaches to the anterior labrum of the shoulder capsule. This muscle is so involved in shoulder problems, that we don't know how you can ignore it. In fact, when it is so spasmed, it messes up with our shoulder checks.
We now recognize when it is doing this, and we do muscle work on the Biceps Brachii. Now we can continue checking for the shoulder check.
If we gave you any of the above Humerus subluxation patterns above, that means that we either cleared your Biceps, or you did not have a Biceps Brachii problem
Subacrominal or Subdeltoid Bursitis
Both these bursas are connected, so I doesn't matter which one is inflammed. You got to deal with both. They are right above the upper arm bone (humeral head). A bursa is a shock absorber. You want to not let the synovial lubricating fluid in the joints dry up, causing bursitis. Dr. Walker recommends a daily juice of 8 ounces of Carrot, 4 ounces of Radish, and 4 ounces of Watercress. This will help restore normalcy to the bursa
(Fresh Vegetable and Fruit Juices. N.W Walker D.Sc)
I would also work on the upper trapezius and middle deltoid muscles. If the upper trapezius and middle deltoid muscle gets tight, it pulls the head of the humerus up under the acromion.....also causing Subacromial Bursitis. Too make matters worse, this superior head of the humerus further compresses the Supraspinatus muscle.
You must work these muscles to get the humeral head down, this will decompress the supraspinatus. When this muscle is decompressed, you can now work on it.
James Waslaski. Orthomassage