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  • Writer's pictureDr. Melissa Adams

Shoulder Pain & Quadrangular Space Syndrome (QSS)


Man grabbing his right arm with his left hand, his mouth open as though he is in pain

In our office, we see many individuals with shoulder complaints, so much so that we now work on nearly every patient's shoulders.


We have had a few cases of suspected/likely Quadrangular Space Syndrome and have managed to help them through chiropractic care, exercises and stretching at home, as well as massage, trigger point work, and often decreasing the activity likely causing the pain and discomfort.


Most of those with this syndrome have pain on the outside and back of their shoulder, it often isn't in one specific location (not something they can use one finger and point to a location) but is more of a diffuse pain pattern. Our patients will say it hurts "here" and may use their entire hand to demonstrate a large area of discomfort and/or pain.


Additionally, many will report general and diffuse pain throughout the entire affected arm as well as fatigue or a weak feeling.


QSS, although considered "uncommon," it is more common in individuals who are doing things over their head on a regular basis. In sports, this can be football or volleyball.


In our office we have seen it in equestrian riders primarily - likely due to their repetitive motions that involve their arm over their head such as grooming/washing their horse and tacking up their horse. This condition also seems to be more likely and more easily aggravated in those who are "woahing" with their horse more than others, involving the specific motion required in their shoulders.


In our office, we take a whole-body approach to care, particularly since we see many individuals who have been riding horses or doing other things with their body for many years. This whole-body approach helps with shoulder complaints as well as the impact of their shoulder complaints, on their neck and spine function.


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