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Frozen Shoulder


The most frequently heard medical explanations for shoulder pain include arthritis, bursitis, tendinitis, rotator cuff injury, adhesive capsulitis, and loss of joint cartilage. CAT scans, X-rays, MRIs, and other tests often seem to substantiate such diagnoses.

Even in the absence of objective evidence, shoulder pain alone is assumed by most physicians to be proof that the rotator cuff or the shoulder joint itself is in trouble. As a consequence, exploratory surgery, forced mobilization, and even replacement surgery for shoulder joints are commonplace and heavily promoted.

An Opposing View

In opposition to these conventional medical practices, Doctors Janet Travell and David Simons, in their widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual, assert that myofascial trigger points (tiny contraction knots) in overworked or traumatized muscles are actually the most frequent cause of pain and loss of mobility in the shoulder.

Even when a shoulder joint has suffered a verifiable injury, Travell and Simons believe that trigger points always contribute a major part of the pain. They stress that shoulder pain referred from trigger points can be every bit as intense and debilitating as pain from a damaged shoulder joint.

Frozen Shoulder

Trigger points in the four rotator cuff muscles that cover the front and back of the shoulder blade are the most frequent cause of shoulder pain. But up to twenty muscles are involved in operating the shoulder and all of them are vulnerable to strain.

When a shoulder muscle is made dysfunctional by trigger points, other muscles have to compensate. Under the extra burden, each muscle acquires trigger points in turn, until every muscle in the region is in trouble. This can lead to progressively limited movement of the arm, ending ultimately in a frozen shoulder.


Travell and Simons quote other researchers who believe that trigger points may actually be the root cause of true osteoarthritis and other kinds of joint deterioration. This is because muscles afflicted with trigger points become shortened and stiff.

When this happens, even normal movement puts undue strain on muscle attachments at the joints, which can eventually result in damage to connective tissue and distortion of the joints themselves.

Popping in a shoulder joint is evidence that muscles afflicted with trigger points are straining and partially disarticulating the joint.

Are Painkillers Bad Therapy?

Painkillers are ordinarily prescribed for shoulder pain, although they can be the worst kind of therapy because they don’t fix the problem; they only diminish your awareness of it.

The use of painkillers risks making your shoulder problem worse by allowing you to go on with the same activities that caused the problem in the first place! Prescription drugs are not a good therapy for shoulder pain. They only deaden your awareness of the problem.

Stretching Questioned

Exercising and stretching a bad shoulder can irritate the trigger points that are causing your pain and worsen it. With shoulder muscles in particular, stretching and exercising should not be done until after all trigger points have been deactivated.

Some people tolerate stretching extremely well. Many others do not. Unfortunately, when stretching doesn’t work, the therapist too often writes it off as the patient’s non-compliance and prescribes additional stretching! Amazingly, trigger point therapy is not yet taught in most physical therapy schools.


You don’t have to wait for the world of medicine and physical therapy to catch up with the science of trigger points and referred myofascial pain. You can take care of shoulder pain yourself with trigger point massage. Here’s a sample of what you can do:

self treatment

The illustration shows trigger points in the infraspinatus muscle, which covers the outside of the shoulder blade.

These trigger points are the most common cause of pain in the front of the shoulder, commonly misdiagnosed as bicipital tendinitis.

There are trigger points in more than 20 other muscles that can contribute to shoulder pain and frozen shoulder. You’ll need some guidance to know how to find and treat them effectively.

self treatment
self treatment

The drawing on the left shows the pain pattern.

The drawing on the right shows massage of the infraspinatus muscle with a tennis ball or lacrosse ball against a wall.

Six to twelve short strokes make a treatment, but treat several times a day.

trigger points workbook

In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies has simplified Travell and Simons' extensive research into myofascial pain and made it accessible to the layman. His innovative methods of self-applied trigger point massage will relieve shoulder pain and frozen shoulder when trigger points are the cause.

To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.

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