Shoulder Pain
The shoulder is the most mobile joint in your body, which is exactly why it is the easiest one to wreck. It is four joints working as one. Dr. Andrew Allen evaluates all of them, not just the spot you point to.
Over 20 years of experience · Wheat Ridge, Arvada, Lakewood, Golden & West DenverYou have quietly stopped doing things
You reach for the seatbelt with the other arm now. You stopped pressing overhead at the gym. You take your jacket off in a specific order. You cannot sleep on that side, so you have rearranged your entire bed around it. Shoulders do not usually announce themselves with one dramatic moment. They shrink your life a quarter inch at a time until one day you realize you have built an entire set of workarounds. Someone probably told you it is a rotator cuff thing and to rest it. Rest does not rebuild control, and the shoulder does not get better on its own.
How shoulder pain actually shows up
Where it hurts and when it hurts narrows the field fast. These are the patterns we hear every week:
The painful arc
Fine at the bottom, fine at the top, agony in the middle of the range. Classic impingement pattern, and one of the most common presentations we see.
Cannot sleep on that side
The single most reported shoulder symptom. Night pain is often the thing that finally makes people call.
Cannot reach behind your back
Getting a wallet, a bra strap, or a seatbelt becomes a negotiation. Loss of internal rotation is a very specific and very findable pattern.
Deep ache in the outer arm
Not at the shoulder itself but partway down the outside of the upper arm. That is a classic rotator cuff referral, and it fools people constantly.
Weakness lifting overhead
It is not just painful, it is genuinely weaker. Weakness with pain and weakness without pain mean different things, which is why we test both.
Clicking and catching
Noise on its own is rarely a problem. Noise with pain or with a sense of catching is worth evaluating properly.
It froze up
Range disappearing progressively in every direction, often without a clear injury. Adhesive capsulitis has a distinct pattern and a distinct timeline.
Pain at the top of the shoulder
Right on the shelf where the collarbone meets. Different joint, different problem, often confused with the cuff.
It came with neck pain
Very common, and a genuine diagnostic fork. Nerve referral from the neck imitates shoulder pain well. See neck pain.
Rotator cuff is a location, not a diagnosis
Your shoulder is four joints and roughly seventeen muscles coordinating in real time. When it hurts, something in that system stopped coordinating. These are the root causes Dr. Allen is actively ruling in or out:
Scapular dyskinesis
Your shoulder blade has to rotate upward and tilt back as you raise your arm, or the space the cuff tendons pass through closes down on them. When the scapula does not do its job, the cuff gets pinched by design. This is the most common driver we find, and it is why treating the cuff alone fails.
A mid back that stopped moving
You cannot get your arm fully overhead without thoracic extension. If the mid back will not extend, the shoulder has to find that range somewhere it does not exist. See upper back pain.
Rotator cuff tendinopathy
Real, common, and usually a capacity problem rather than a damage problem. The tendon got asked for more than it was prepared to give, repeatedly.
Subacromial impingement
Tendons and bursa getting compressed in a space that should be bigger. Almost always a mechanics problem upstream, which is good news, because mechanics can be changed.
Cervical nerve referral
A cervical nerve root can produce pain that lives entirely in the shoulder and arm with a completely healthy shoulder joint. This gets missed constantly. Related: herniated discs.
A tight and dominant front side
Pecs and lats that have shortened pull the humeral head forward in the socket. Now every overhead rep grinds. You cannot stretch your way out of this from behind.
Labrum and capsule
The rim and the sleeve. Catching, instability, or a shoulder that feels like it might not stay put warrants specific testing rather than assumptions.
AC joint irritation
The joint on top where the collarbone meets. Common after a fall onto the shoulder, and it produces a very localized, very reproducible pain.
Adhesive capsulitis
Frozen shoulder is its own animal with its own phases, and treating it like an impingement makes it worse. Identifying which phase you are in changes everything about the plan.
Load outpacing tissue
You added volume, weight, or a new sport faster than the tendon adapted. Extremely common in athletes and active adults, and very fixable once identified.
How Dr. Allen figures out what is actually wrong
You get evaluated and treated on day one. Not a clipboard and a handshake and a see-you-next-week.
We listen to the whole story
When it started, whether there was a specific moment or it crept in, what you cannot do anymore, and what you are actually trying to get back to. Climbing, throwing, and sleeping are three different goals with three different plans.
We watch the shoulder blade, not the shoulder
Dr. Allen watches from behind as you raise and lower your arm. Whether your scapula rotates smoothly or wings, hikes, and shrugs tells us more than the painful spot ever will.
Orthopedic and neurological testing
Specific tests to differentiate cuff from labrum from AC joint from capsule from cervical referral. Strength testing in isolation. This is what separates a real diagnosis from a shrug and the word tendinitis.
We clear the neck and the mid back
Every shoulder evaluation here includes the neck and thoracic spine, because a meaningful share of shoulder pain is generated somewhere other than the shoulder.
We connect it to your life
Your training split, your desk, your bike fit, your sleep position, your sport. The cause is usually sitting in your calendar.
You get treated the same day
You leave your first visit having actually been treated, and knowing in plain English what is going on and what the plan is. If your case needs an orthopedic opinion or imaging, Dr. Allen will say so directly.
Colorado is hard on a shoulder
We would not live anywhere else. But the Front Range lifestyle has a signature, and after twenty years Dr. Allen can usually guess your hobby from your movement pattern.
Climbing in Golden and the canyon
Clear Creek Canyon and the gym scene here are enormous. Climbing is repeated end-range overhead loading with a lot of internal rotation. Shoulders are the sport’s tax.
Ski pole plants and falls
Catching yourself on an outstretched arm at speed is how a lot of AC joints and labrums are introduced to us. February is a busy month.
Snow shoveling
Repetitive loaded lifting and throwing with cold muscles, often first thing in the morning. The cuff does not enjoy this and will tell you.
Mountain biking
Absorbing chatter through the arms for two hours, plus the occasional over-the-bars. Both find the shoulder.
Cycling on Clear Creek Trail
An hour supporting your torso through your arms with your shoulders rolled forward. It is a static endurance load nobody counts as training.
The Denver commute and desk
Eight hours with the shoulders rounded forward shortens the front and shuts off the scapular stabilizers. Then you go press overhead at 6 p.m. and wonder what happened.
Fourteeners with a pack
Twenty pounds of strap pressure directly across the top of the shoulders for eight hours, plus pole work on the descent.
DIY and home projects
Overhead painting, drywall, hanging gutters. Colorado homeowners do their own work, and the shoulder funds the project.
Wadsworth and Kipling traffic
Bracing against the wheel in a collision loads the shoulder hard. See our car accident injury care.
How we treat shoulder pain
There is no single technique that fixes a shoulder. Dr. Allen builds care around what your evaluation actually found, which is why no two plans here look the same.
Chiropractic adjustments
Targeted manipulation of the thoracic spine, ribs, and cervical segments that the shoulder depends on, plus the shoulder joints themselves where indicated.
Soft tissue therapy
Hands-on work across the cuff, pecs, lats, and the scapular stabilizers, addressing both the tissue that is guarding and the tissue that is pulling you forward.
Dry needling
Thin monofilament needles into the cuff, subscapularis, and deep scapular musculature that hands simply cannot reach. Often the fastest route into a stubborn shoulder.
Cupping therapy
Decompression-based soft tissue work that may help circulation and tissue mobility across the shoulder and upper back region.
Therapeutic exercise
Scapular control and progressive tendon loading. Tendons need load to heal, not rest. A short, specific set aimed at the deficit we found.
Functional movement assessment
The reassessment loop. We re-test what we tested so you can see the change, and so we know whether the plan is working or needs to change.
Shoulder pain FAQ
Is my rotator cuff torn?
Maybe, and it may not matter as much as you think. Partial cuff changes are extremely common in people over forty who have no pain at all. What matters is whether the shoulder can do its job, which is a question answered by testing, not by assuming. If your presentation suggests a tear that needs a surgical opinion, Dr. Allen will tell you and refer you.
Why does it hurt in my arm and not my shoulder?
Because the rotator cuff refers pain down the outside of the upper arm. It is one of the most reliable referral patterns in the body, and it is why so many people are convinced the problem is somewhere it is not.
Can a chiropractor treat shoulders, or just spines?
Extremities are squarely within chiropractic scope, and shoulders in particular benefit from someone who treats the neck, mid back, ribs, and shoulder as one system, because that is how the shoulder actually works.
Should I rest it?
Rarely, and rarely for long. Tendons adapt to load and deteriorate without it. Complete rest tends to buy you a few comfortable weeks followed by a weaker shoulder. The right amount of the right load is usually the treatment.
How do I know if it is frozen shoulder?
The tell is losing range in every direction, including when someone else moves your arm for you, usually without a clear injury. It has phases, and knowing which one you are in completely changes what should be done. Getting that wrong is genuinely counterproductive, which is why it gets tested for specifically.
Will I have to come three times a week forever?
No. There are no long-term contracts and no forced treatment plans here. The goal is to get you out of pain, teach you what caused it, and send you back to your life.
Do I need an MRI?
Usually not to start. Imaging is valuable when the findings warrant it or when a surgical decision is on the table. Dr. Allen will tell you honestly if your case is one of them.
Do you take my insurance?
Coverage questions are best answered directly. Call or text (303) 351-0744, or check the FAQ.
Stop managing it. Start fixing it.
You should be able to sleep on your own shoulder and reach your own seatbelt. Get a real evaluation from a doctor with twenty years of hands, and find out what is actually going on.
Lakeside Spine & Injury Center · 6073 W 44th Ave #101, Wheat Ridge, CO 80033 · Proudly serving Wheat Ridge, Arvada, Lakewood, Golden, Edgewater, Applewood, and West Denver.