The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more susceptible to injury. Shoulder pain can stem from one or more of the following causes:

Thoracic outlet syndrome results when there is compression of the neurovascular structures that are located in the neck. Symptoms of thoracic outlet syndrome include shoulder or arm pain, tingling or numbness (paresthesias), and varying degrees of muscle weakness.

Frozen shoulder, or adhesive capsulitis, involves progressive pain and loss of motion in the shoulder joint. The exact cause of adhesive capsulitis is unknown, but it is typically seen after injury or immobilization of the shoulder joint and is more common in females than males. Frozen shoulder results from a thickening and shortening of the capsule that surrounds the shoulder joint.
The normal progression of frozen shoulder has been described as having three stages.

Most sufferers of frozen shoulder will be fully recovered within 4 to 6 months but some cases have lasted for up to three years, although these are extremely rare.

Massage is one of the best ways to increase blood flow to the injured area, and of course the oxygen and nutrients that go with it. The other benefit of massage is that it helps to reduce the amount of scar tissue which is associated with all muscle, tendon and joint injuries.

If you’ve ever been working out at the gym, pushing a heavy weight and heard a popping sound in your shoulder; or skiing down the slopes when you landed shoulder first in the snow; or playing a game of tennis, when all of a sudden there's a sharp pain in your shoulder, then you recognize the cause of a shoulder injury. Excessive force, or putting too much strain on the tendons of the shoulder muscles when you lift something that is too heavy or when a force is applied to the arm while it's in an unusual or awkward position are reasons for the pain. Whether you call it a rotator cuff tear or shoulder tendonitis, it's the same thing - a tear, strain, or inflammation in the rotator cuff muscles and tendons.

The two common symptoms of a shoulder injury are pain and weakness. Pain is not always felt when a shoulder injury occurs, however most people who do feel pain, report that it's a very vague pain which can be hard to pinpoint. Weakness, on the other hand, is the most reliable symptom of a shoulder injury. Common complaints include an inability to raise your arm above your head or to extend your arm directly to the side or in front. In most cases, the larger the tear or damage to the tendons, the harder it is to move your arm and the injured area.

The shoulder area is very tendinous and receives very little blood supply as well as very little oxygen and nutrients. This lack of blood supply is also the reason why a shoulder injury can take quite a lot of time to heal.

The rotator cuff is comprised of four muscles. These individual muscles combine at the shoulder to form a thick "cuff" over this joint. The rotator cuff has the important job of stabilizing the shoulder as well as elevating and rotating the arm. Each muscle originates on the shoulder blade, or scapula, and inserts on the arm bone, or humerus.

The four muscles that form the rotator cuff are the supraspinatus, infraspinatus, teres minor, and subscapularis.

Supraspinatus - The supraspinatus muscle originates above the spine of the scapula and inserts on the greater tuberosity of the humerus. The supraspinatus abducts, or elevates, the shoulder joint. It also works with the other rotator cuff muscles to stabilize the head of the humerus in the glenohumeral joint, or shoulder joint.

Infraspinatus - The infraspinatus muscle originates below the spine of the scapula, in the infraspinatus fossa, and inserts on the posterior aspect of the greater tuberosity of the humerus. The infraspinatus externally rotates the shoulder joint. It also works with the other rotator cuff muscles to stabilize the head of the humerus in the glenohumeral joint, or shoulder joint.

Teres Minor - The teres minor muscle originates on the lateral scapula border and inserts on the inferior aspect of the greater tuberosity of the humerus. The teres minor muscle externally rotates the shoulder joint. It also works with the other rotator cuff muscles to stabilize the head of the humerus in the glenohumeral joint, or shoulder joint.

Subscapularis - The subscapularis muscle originates on the anterior surface of the scapula, sitting directly over the ribs, and inserts on the lesser tuberosity of the humerus. The subscapularis muscle works to depress the head of the humerus allowing it to move freely in the glenohumeral joint during elevation of the arm. It also works with the other rotator cuff muscles to stabilize the head of the humerus in the glenohumeral joint, or shoulder joint.

The earlier a shoulder injury is treated, the better. The first 48 to 72 hours are crucial to a complete and speedy recovery.  Again, massage is one of the best ways to increase blood flow to the injured area, and supply oxygen and nutrients that are needed for repair and recovery. The other benefit of massage is that it helps to reduce the amount of scar tissue which is associated with all muscle, tendon and joint injuries.

A recent five year study in the US concluded that traditional approaches of bed rest, traction, and surgery were in general ineffective and overused. The British Medical Association agrees with Canadian and US research, that mainstream medical methods tend to treat symptoms and not the cause.

They further concur that between 70-90% of all back pain is caused by muscle spasm. And also that:

There can be many sources of low back pain involving the vertebrae, intervertebral disks, and nerves. But there are two things that are seldom acknowledged:

Whether your back pain is muscular or vertebral in origin, the basic rule remains: first do no harm. It only makes sense to begin with the least risky, least invasive treatment available, then escalate if necessary. That treatment is massage therapy. If it isn't effective, the other treatments are still available. But if it is effective, a lot of time, pain, risk, and money have been saved.

Low back pain caused by soft-tissue problems is likely to originate in one or more of three different locations:

Iliopsoas - This is the primary hip flexor (its chief assistant being rectus femoris), running down through the abdominal cavity and the groin to the lesser trochanter. But its origins, meaning in this case its anchor points, are the inner surface of the ilium (iliacus muscle) and the transverse processes of the lumbar vertebrae -- which means that every lifting of the leg pulls on the pelvis and the lumbar spine.

Quadratus lumborum and its neighbours - Quadratus lumborum is the muscle between the bottom rib and the top of the pelvis. It is a deep muscle, and is situated underneath (deep to) the lumbar paraspinal muscles. If there are problems in quadratus lumborum, there are also likely to be problems in those thick muscles near the surface on either side of the spine. In addition, muscle problems are invariably accompanied by connective tissue problems. This area, unprotected as it is by any skeletal structures, is thick with connective tissue: the thoracolumbar fascia, the gluteal aponeurosis, and other tough connective tissue cover and surround these muscles.

The buttock muscles - These include the three gluteal muscles (gluteus maximus, medius and minimus), and the deep lateral rotators of the hip, especially piriformis. Piriformis pain is often mistaken for sciatic pain, pain from this muscle runs down the back of the leg down to the heel in a similar pattern to sciatic pain.  The piriformis muscle is one of many muscles that can tighten and entrap the sciatic nerve.

Certainly other muscles can and do affect low back pain, but these three muscle groups, all heavily involved in the day-to-day demands we make on our bodies, are the chief sources. With careful examination a skilled massage therapist can find the trouble spots, and appropriate treatment can yield relief that many people had despaired of finding.

Sciatica can cause severe pain because of compression or irritation of the nerve roots exiting the spine that form the sciatic nerve.  The sciatic nerve is the largest and longest nerve of the body, reaching about the size of your pinky or forefinger in diameter, formed by four or five nerve roots branching off each side of the spinal cord and down the back of each leg.  Typical problems are pain in the buttock, the knee area, near the foot and sometimes through the entire leg and foot.  It can also cause a deep ache of the leg and cramping-like sensations of the muscles, pins and needles, burning sensations, numbness and tenderness.

There are also conditions which can mimic sciatica called "false" sciatica such as Piroformis Syndrome where the sciatic nerve is entrapped by the piriformis muscle in the buttocks area.   Piriformis Syndrome is also called "back pocket sciatica" because pressure on the piriformis muscle and sciatic nerve can be caused by sitting on a wallet in the back pocket of a person's pants.  Another problem that can mimic sciatic pain is having trigger points in the Gluteus Minimus muscle.  The trigger points in this muscle can refer pain sensations down the back of the leg along the path of the sciatic nerve and also on the outside of the leg.   Massage therapy and bodywork are very beneficial in relieving symptoms and promoting recovery. Massage Therapy can help Sciatica, Sciatic Nerve Pain, and conditions which mimic sciatica.  Massage therapy can help relax muscles, release trigger points and abnormal tissue adhesions, and improve posture to relieve the pressure on nerve roots and other sensitive structures.

Tendonitis describes inflammation, swelling, and irritation of a tendon. Tendonitis is a painful condition that is felt most at the tendon insertion site. Tendons are bands of fibrous material that attatch muscle to bone.  Every muscle has a tendon that attaches it to bone.  When these structures are irritated, they swell and become inflamed.

The tendons become inflamed for a variety of reasons, and the action of pulling the muscle becomes irritating. If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful.

The most common cause of tendonitis is overuse. Commonly, individuals begin an exercise program, or increase their level of exercise, and begin to experience symptoms of tendonitis. The tendon is unaccustomed to the new level of demand, and this overuse will cause an inflammation and tendonitis.

Achilles Tendonitis

Achilles tendonitis is an overuse injury, meaning that repetitive use of this tendon results in little tears of the tissue. Over time, swelling and pain result. Common activities or conditions that result in Achilles tendonitis include:

The symptoms of Achilles tendonitis usually progress gradually over time. You may initially experience them first thing in the morning, or during times of increased activity.

Common symptoms of Achilles tendonitis include:

Plantar fasciitis is inflammation of the plantar fascia, a thick fibrous band that connects the heel bone to the base of the toes. Plantar fasciitis is an overuse injury and occurs when the long, flat ligament along the bottom of the foot develops tears and inflammation. This ligament is called the plantar fascia and it extends your five toes and runs along the bottom of your foot, attaching to your heel. When you walk or run, you land on your heel and raise yourself on your toes as you shift your weight to your other foot, causing all your weight to be held up by your plantar fascia. Such repetitive force can pull the fascia from its attachment on your heel and cause damage and plantar fasciitis.

People with plantar fasciitis experience pain across the bottom of the feet. Discomfort with plantar fasciitis is more common in the morning after wakening. Pain is initially felt at the base of the heel, and then radiates across the arch of the foot to the base of the toes.

Plantar fasciitis is more commonly experienced in females, people who are overweight, and workers who spend most time on their feet. People with high arches, tight calf muscles, and athletes like runners and tennis players who run often are also at increased risk for developing plantar fasciitis.

Massage is indicated for plantar fascitis.  It can help release tension in deep calf muscles that put strain on the plantar fascia. It can also help to affect the development of scar tissue at the site of the scar.

Many pain problems in adults are the result of postural misalignments that may have developed in childhood or adolescence. These misalignments generally have little to do with bones; they are mostly soft-tissue problems. If a tent is not standing straight, we don't adjust the tent pole, we adjust the ropes that are holding the tent pole in place. Bones go where muscles put them, and bones stay where muscles keep them.

A line can be drawn, along the line of gravity, through the nose, the sternum (breastbone), the navel, the pubic symphysis (the middle of the pubic bone), and ending at a point halfway between the feet in a natural and comfortable standing position. At least, that's the course the line will follow on a well-balanced body. A similar line can be drawn along the side of the body that will pass through the ear, the shoulder joint, the hip joint and just in front of the ankle. One easy way to check these lines on a person is with a plumb line -- a string with a weight at the end.

There are other signs of balance: the shoulders and shoulder blades should be level, and the inner edge of each shoulder blade should be the same distance from the center of the spine as the other. The hips and the buttocks should be level, and the pelvis should be tilted forward no more than 10 degrees. The shoulders should not be rotated inward. The kneecaps and the feet should point forward. In walking, the legs should swing freely forward without twisting to one side or the other, and the arms should swing freely in inverse coordination with the legs.

These are not arbitrary rules. This is a description of a body that is balanced and well-aligned in relation to gravity; that is, a body that is able to use gravity to remain upright and move freely, rather than constantly fighting it. A body that is out of balance will be using a great deal of energy fighting gravity, and, in the end, gravity wins. In addition, the tissues that are pulling and holding the body out of alignment, and those enlisted in the constant struggle against gravity, are in a state of distress that grows more pronounced and more refractory over time.
Postural massage therapy is focused on the whole body, and the responses of the whole body to all of the work must be observed.  Sessions should be no more frequent than twice a week (to give the tissues time to respond to the work), and no less frequent than once every two weeks (to keep from re-establishing old patterns).  Actual treatment procedures employ a synthesis of manual techniques.  The order of work has to do largely with two interconnected elements: a) working from superficial to deeper structures, and b) developing increasing trust on the part of the client at both the conscious (intellectual and emotional) and unconscious (emotional and physical) levels.

The ultimate objective is to work on the whole body, releasing fascia and muscle constriction in all areas, so that, rather than by forcing the body into some arbitrary postural standard, the body is set free to find a relaxed, comfortable, efficient and gravity-friendly posture in all its activities.