Emma asked The Guru for the following Physiotherapy Advice: Dear Guru, I have had shoulder pain in my left shoulder for a few years now.  It is becoming increasingly more painful and when I have had massages recently, I can feel a clicking and grinding feeling where the pain is.  It really feels like the pain is in, underneath my shoulder blade.  Also when I have it massaged, it begins to get very hot, and feels like it is burning. Would you recommend a sports massage? The massages I have had before, have not been professional (as in only for relaxation rather than pain management.) Any help you could give me would be great. Best Regards Emma

Hi Emma Ummm, no I don't think so. Massage is massage - well sort of. It's just pushing tissue around in certain directions at a certain speed with a certain amount of force. You've had some of that. It's time to look beyond the symptoms and deal with the cause. You don't just wake up one day with knots and crunchy bits. They develop because your muscles are being forced into something they don't usually do - time and time again. This is super common. The most probable cause is you've got a really stiff thoracic spine (due to posture) but it probably doesn't cause the pain. The pain is most likely being referred from your neck because you poke your chin out to see where you're going. The muscles around your neck are desperately tying to control this, and failing. I think you need to go and see someone who can assess the front aspect of your neck - which should reproduce your pain. Get this bit treated, get you thoracic spine moving and learn to control your head on neck posture. Don't stretch your neck and have a look at your work station posture. There are some great stretches you can do over a foam roller - lying on it lengthways. Cause change, don't chase pain! The Guru Six Physio