Case 32 – Persistent Right Shoulder Pain Driven by Abdominal Tension Imbalance

This client presented with long-standing, severe right shoulder pain. During gait and standing assessment, I observed a consistent leftward head deviation. Interestingly, when the head was corrected to a neutral position in standing, the client experienced sharp shoulder pain. However, in sitting or lying positions, the head could remain centred without discomfort.

Postural and head-tilt assessment revealing abdominal and rib cage tension as the underlying driver of persistent right shoulder pain.

Further assessment revealed abnormal tension through the left abdominal wall and rib cage. This imbalance caused the left ribs to be pulled inferiorly during standing, creating a compensatory head tilt and uneven load through the cervical spine and right shoulder.

Following targeted abdominal and fascial release, the client was immediately able to maintain head alignment in standing. Right shoulder pain reduced significantly without any direct shoulder treatment, confirming the shoulder pain was a secondary compensation rather than the primary source.

Clinical Practice: Heal Young Massage

Evidence-based remedial massage and movement rehabilitation services.