Shoulder and neck pain, why joint capsules are an often overlooked cause of chronic upper body pain.



Shoulder and neck pain, why joint capsules are an often overlooked cause of chronic upper body pain.

Shoulder and neck pain as well as elbow and wrist complaints are more common than most people believe, with patients often not getting the relief they want or deserve. A diagnosis such as shoulder tendonosis, tendonitis, shoulder impingement or torticollis is not descriptive enough for other healthcare providers to fully understand why you are in pain. Often, these terms lead to the use of a drug or a therapy that cannot work because the problem was never fully understood by the treating healthcare practitioner. Your frustration begins with the experience of the provider, their own professional bias, and also the ability to think outside the box through the process of elimination. If your healthcare provider is evaluating only the painful part, while ignoring the rest of you, there is a great likelihood they are missing the mechanism behind why you hurt.

In the book Cheating Mother Nature, what you need to know to beat chronic pain, explains some of the causes of problems such as those mentioned already, which often may not be originating in the painful area. For example, shoulder pain or impingement is often resulting from postural problems created by your body style. Depending on the healthcare provider’s point of view, most are trained to look at, evaluate or test the painful part, without ever looking at the pelvis or feet which may actually be why the impingement exists.

foot overpronation copy

When a person has foot overpronation, which means they have low arches that fall in or feet that turn out, their body will compensate with the shoulders rolling in which not only creates impingement in the shoulder but also can over time create hip capsule and shoulder capsule tightness which leads to more permanent restrictions in the shoulders or hip joints.

shoulder Joint Capsule
shoulder joint capsule

The hip and shoulder capsules will accommodate to altered movement patterns determined by our body mechanics, which over time can become quite painful. When a shoulder joint capsule is very restricted, the term frozen shoulder or adhesive capsulitis is often applied to describe the problem which can be excruciatingly painful and difficult to treat.

Most sports chiropractors will look at their patients from the feet up and have a holistic point of view in the way they evaluate you, meaning they look at the person, not just the painful part. The good news is that a more thorough evaluation can help you avoid an expensive MRI which is not likely to explain to you why the problem developed.  A thorough physical exam can often detect problems such as a loss of shoulder mobility, problems in the pelvis causing shoulder problems, and even figure out if a longstanding problem is now involving the capsules of the hip or shoulder.

Recently, I had experienced a problem such as this, which, with the help of a colleague, I was able to successfully treat a problem that existed in my right shoulder which began with lower back stiffness, upper back, and neck tightness, and shoulder pain which felt like it involved the ribs which began during a doubles tennis game. Prior to experiencing the pain in the shoulder, my upper body was quite stiff. My colleague, a local sports chiropractor through a process of elimination helped me figure out that the right shoulder capsule was quite restricted, which was likely the reason for the pain and discomfort I was experiencing.

A couple of weeks after working on the capsule, I was able to play tennis without pain and had more power in my swing. Since I am a chiropractor, I am not immune to problems like these which our patients often suffer from. The good news is that if diagnosed properly and early, resolving joint capsule problems can resolve problems in the neck, lower back, and shoulder that are often not responsive to other forms of treatment, and are often misdiagnosed.

hip capsule
hip capsule

What are shoulder and hip capsules?

Fibrous tissues that surround the joint, help add stability and protect the joint as seen in the above illustrations.

The muscles that surround these joints and the surrounding myofascia will continuously tighten if the capsule does not allow appropriate motion of the joint.

Common symptoms that can arise from tight hip capsules include;

1. A limp

2. Arthritic hip joint

3. Plantar fasciitis from leg tightness.

4. knee pain

5. Lower back pain

6. Sciatic pain.

Common symptoms that can arise from tight shoulder capsules include;

1. Shoulder Pain

2. Neck Pain

3. Frozen shoulder syndrome

4. Rib or chest pain

5. Lower back pain

6. Pain in the shoulder blades

7. Generalized upper body or lower body stiffness that has not been responsive to chiropractic, exercise or other muscular treatments.

How do you resolve a capsule problem?

Joint capsules deform through a process called plastic deformation. Basically, the material that the capsule consists of assumes a shape that restricts required movement resulting in stress to the other joints and tissues surrounding the area. To reshape the capsule, which allows to improved flexibility, movement and reduces stress in the areas surrounding the joints, stretching regimens are used, with myofascial release treatment to improve the flexibility of the areas that are involved. Chiropractors are ideal for the task of resolving these types of problems because they use manipulation on a daily basis and are well trained in a number of manipulative techniques. Many have also been trained in myofascial therapies including instrument-assisted soft tissue treatment, active release techniques (a trademarked style of myofascial release treatment that is diagnostic in its approach) as well as rehabilitation regimens. Many sports-certified chiropractors have studied these methods and use them daily to good effect. Rather than needing a number of people to help you get out of pain, most chiropractors are one-stop shops for joint capsule relief.

If you are curious about some of the stretching regimens, you can visit our youtube site at There are some examples of shoulder and hip joint capsule techniques we show our patients. To resolve these types of problems in a cost-effective manner, the doctor will loosen up the area surrounding the capsule, then stretch it and then have the patient continue the stretches throughout the week to reinforce the treatment. This speeds the process along for the best outcome. Often, people with degenerated hips can function much better with these regimens without having to endure a hip replacement or perhaps, put it off for years if they are too young (most replacements have an average lifespan of 15 years, so putting it off until your later years is preferable).

Joint capsule stretching protocols can improve flexibility, reduce stiffness and resolve chronic stiffness that is often resistant to treatment. Please feel free to look through our site and read our blog Diary of a NJ Chiropractor, which can be found through Google.

Read Cheating Mother Nature, what you need to know to beat chronic pain available through

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