Volleyball has always been one of my favorite sports to play. So when this woman [who is still an avid volleyball player] came to me with a painful shoulder, I really wanted to be the guy that figured it out.
She plays in a league weekly and sometimes for several hours at a time.
However, she could no longer serve overhand, and it was very painful to spike the ball.
I tested all the muscles of the shoulder and found many that were in a neurologically inhibited state [we typically call them weak].
I will typically test 10 rotator cuff muscle divisions, and she had many of them not working correctly. This means that she had lost the ability to control her arm in the shoulder socket. This is what the rotator cuff muscles do. They fine tune movement.
Without her muscles working correctly, every swing she took was painful. But, as we went about fixing each muscle division, she got better and better.
Even though nothing looked different on the outside, her brain was in better and better control of her arm. Better control means less pain and better all around performance. Vital for any athlete.
In her case the damage had not been extensive enough to warrant any type of surgery, but instead we just had to figure out what was causing the neurological muscle inhibition.
And the cause(s) can literally be anywhere in the body. Detective work is the key.