Dry Needling for Shoulder Pain

Have you had difficulty treating patients with shoulder pain? I’m sure you have, because it’s such a common problem and I see many patients who’ve seen just about everybody in Melbourne before they finally give me a go at trying to fix them.

Shoulder problems are difficult to treat because of the nature of the joint. A very mobile ball & a shallow socket with 14 different muscles that act on the shoulder or scapula, not to mention the effects of the scapulo-thoracic, sterno-clavicular & acromio-clavicular joints.

It’s a minefield!

The purpose of this post is not go into the biomechanics of shoulder pain but to put forward an unusual connection that I’ve found in my practice.

Whatever your profession and whatever your treatment methods you’ll no doubt consider and treat the local muscles around the shoulder joint. We all do this in our different ways.

The next time you treat a chronic shoulder problem why don’t you consider the lattisimus dorsi? 

You’re probably thinking, but I do. 

But do you consider the ipsi-lateral attachment on the posterior iliac crest? 

Probably not.

I’ve found that in almost every type of shoulder dysfunction including rotator cuff injury, frozen shoulder, bicipital tendinopathy, SLAP tears & instability, the lattisimus dorsi is affected not only in the axilla but over the thoraco-lumbar fascial connection to the iliac crest & sacrum.

Together with another common culprit & a lat dorsi synergist, Teres Major is also very rich in myofascial trigger points in patients with shoulder pain.

I’ve found that the iliac crest attachment is exquisitely tender, particularly over the lateral border. Dry needling the latissimus Dorsi and the Teres Major is a great way to release the taut bands commonly found in this location and help your patients with should pain.

Try finding the trigger points next time you see a patient with shoulder pain.
Dr Wayne W Mahmoud
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