The following post may have some useful ideas on aim for those with significant shoulder, elbow or wrist problems, or thoracic spine pathology.
http://www.targettalk.org/viewtopic.php?t=37963
Please note, some consider this method totally idiotic or counterproductive.
Here are the relevant excerpts:
Aim:
As to the aim, there are basically two methods, one the static, and one the dynamic method (firing while the gun is moving downward to the target point). In FP shooting, the dynamic may work better as muscle fatigue is less. The dynamic method shooting with the gun moving) takes a little practice to learn, but with the FP, the learning is easiest as the movement of the gun is disturbed so little by pulling the trigger. The same method can be used with other guns as well, but the heavier the trigger pull, the more difficult this method becomes.
The dynamic method also reduces the effects of hand and arm tremor. If using the static method, do NOT lock the arms, but leave them slightly flexed at the elbows to reduce tremor. Also it may be necessary to learn to "time" any tremor present.
The inverse dynamic approach, of raising the gun and shooting as the gun rises, also can be used. The advantage of that is clearer view of the target point, and better ability of the brain to time the movement of the gun. Also remember to focus NOT on the overall target, but on a specific 2x2mm spot of the target as your aimpoint.
The perception of drawing a line to the target by the dynamic method is a perception only. The actual mechanism is that the brain and optic system are extremely good in timing and advance targeting of moving objects, physiologically called "anticipation" targeting. This accuracy is so good, even in lowly humans compared to birds or cats, that the timing and targeting of the anticipation method can be better than the static method.
Muscle tremor primarily is a static phenomenon, that is suppressed partially or completely during movement. As a result, the moving gun method avoids or at least markedly reduces the error from tremor. The brain also is more adept (hard wired) for advance or anticipation targeting, than it is for timing tremor and adjusting the aim to compensate for that.
With a free pistol the trigger pull should be light enough that you do not actually pull the trigger consciously to fire the gun. It should fire as soon as you think about firing. This relates to the details of brain control of motor movement more than anything else, which are a 2 stage process with dual circuits that can override one another.
In the end, whether the static or dynamic method is better depends in part on the individual shooter, and how their brain works (or malfunctions).
To further confuse the situation, rarely one comes across an individual whose accuracy consistently is better than should be possible with the gun and ammunition used. Some of these individuals accomplish this by remembering variation the gun has with each shot in the sequence, and adjusting for it. However, that doesn't explain the whole picture, and other things must be talking place, which are pretty hard to understand.
To test the methods, the area vs. point aim approach can be tested with just 20-50 rounds. It takes a bit longer to try out the dynamic vs static aiming, but 50 rounds with the "new" method (whichever it is for the shooter) will be enough to give an indication of whether it will help or not. As mentioned above, there is individual variation in whom it helps.
Dynamic tracking and aim in the horizontal plane: This of course is used when the target is a moving object. However, due to the arm drift due to gravity, it is more difficult to learn, than the vertical dynamic aim method. Circular dynamic aim, where the gun is moved in a spiral or arc, probably is something cats and birds can do with ease, but humans find it much more difficult.
Technical references are included in the original post, towards the end.
Pistol shooting with shoulder and elbow problems
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