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Coaches Q&A: Why does my shoulder hurt when I run?

I was asked to participate in a coach’s panel today at a 5K race in phoenix. It was part of a series that Aztech Training is conducting to help runners get educational information with regard to their running, program, and nutrition. This will be taking place at several of the runs this summer and then during the weekend long runs in August in preparation for the Phoenix PF Chang Marathon. So, if you are planning on running any of these races, please stop by and say hi! Also, if you need a team to join for the PF Chang Marathon, AZtech really is the best in the city!

I have decided to take some of the questions and answer them here since some that are reading this blog may benefit from it. I will tackle a few of the questions each week and hopefully, they will spawn other questions from my readers (if you have any questions, just leave it in the ‘comments’ section at the bottom of each entry and I will try to get to it).

Q: Why does my shoulder hurt when I run, and what can I do about it?

A: This is a great question and one that I happen to get a lot. I will say that without being there to see you run or do a proper assessment, it is tough to pin it to just one thing. As well, I am not a doctor or physical therapist, so I do not (ever) diagnose anything. I do put people through assessments (both movement assessment and, now that I have been working on completing my massage licensure, more specific soft tissue assessments). From there, I try and get any idea of what may be causing the pain and determine whether or not I can help you with this problem. When I need to, I do refer out to the physical therapist for a specific diagnosis. So, to answer the second part of your question, what you can do about it is go to see a professional to determine what the problem is and get on some sort of treatment plan. This can be a trainer who has a solid assessment, a massage therapist (specifically someone who focuses on orthopedic massage and neuromuscular techniques) or a doctor or physical therapist (for a specific diagnosis).

As we say, never chase pain. All that means is that if you have some sort of pain, it may (or may not) be due to the specific structure that is giving you the problem. You really need to look at everything when you are analyzing why someone hurts. Symptoms are nothing more than presentations of a problem. They don’t tell us WHY you hurt, they just tell us that SOMETHING is wrong. It is up to the professional to figure out what that something is. When it comes to shoulder ‘pain’, there are a few things that I look at:

1) Breathing patterns- Is the person an upper chest breather? This tends to create lots of tension in the shoulders and chest and can cause postural problems or exacerbate already existing postural abnormalities (especially late in a race when you are more fatigued).
2) Thoracic spine mobility
3) Cervical spine mobility
4) Scapular movement and position
5) Soft tissue assessment
6) Shoulder mobility and flexibility
7) Scapular stabilizer strength
8) Core strength

9) Posture- Not just upper body posture or thoracic spine posture, but the entire body. Remember, if something is off in the foot, it will affect everything above it. Sometimes, the pelvis can be out of position, causing posture to change all the way up the chain. Total body posture is a big one and it is always the first thing I look at when assessing someone (even though I didn’t list it first here).

As I stated earlier, it is also important to look at how you run late into the race, in a fatigue situation. Runner’s, especially distance runners, don’t always like to do strength training as they feel that it will hinder their performance. I do feel that some of the problems they have can be alleviated with proper strength work. Again, seeing a professional to help determine areas of weakness is really critical to ensuring that you are on the right program at the right time in your training season.

In other news…Tiger Woods Ya’all! Tiger Woods! What an incredible US Open it has been so far. I can’t wait for the playoff round tomorrow. It is almost unfair that I have to work. I feel like it should be some sort of holiday!