Why are shoulders so interesting? Hmmm, not convinced..? Shrugging at this notion?
Well, just there is a great example, not only are our shoulders designed to move in all planes of movement from reaching overhead to behind our back allowing us to use our hands for an endless list of possibilities, but they can be used to express human emotion too! We can shrug to say “what that’s not interesting;)” and we can reach them out forward to wrap our arms around our loved ones for a warm hug!
When speaking of the shoulder we refer to three major parts, firstly the Glenohumeral joint; shoulder socket including humerus (upper arm bone), labrum, joint capsule and ligaments. This ‘ball in socket’ shaped joint has a smaller shallow socket ie. Glenoid, for a larger ball ie humerus to sit on. This size mismatch provides a greater freedom of movement but comes at a cost in stability emphasizing the importance of having adequate strength in the shoulder muscles for improved daily function and reducing risk of injury.
Secondly, The Scapulothoracic joint; the shoulder blade moving on rib cage and finally the Collar bone which meets the tip of the shoulder blade to form ACJ or Acromioclavicular joint. Together the joints of the shoulder have a multitude of muscles surrounding to produce movement and provide dynamic stability. The Deltoid; used predominantly for lifting the arm forward and to the side, or a group of muscles referred to as the Rotator Cuff; used to stabilize the shoulder in the socket when lifting the arm, and the Trapezius; used to shrug those shoulder blades.
Having such wide range of movement allows for boundless possibilities but it can mean a sacrifice in stability which may lead to increased risk of injury during high speed and contact activities like sport or even falling on an out-stretched hand. The following injuries typically occur due to high level forces applied to the arm and shoulder however can happen unexpectedly.
As the shoulder is the connecting point for upper limb and torso it is no surprise that the shoulder is exposed to high volumes of demand and work from day to day. High levels of work, especially repetitive movements or sustaining out-stretched positions under load can also lead to shoulder pain without sustaining a sudden injury. Also, shoulder pain can arise from a joint instability or laxity of connective tissues which can be genetic.
Some common acute or traumatic shoulder injuries may include:
- Glenohumeral Dislocations
- Acromioclavicular Separations / Dislocations
- Clavicular Fracture
- Humeral Fracture
- Scapular Fracture
- Labral tears
- Ligament injuries
- Rotator Cuff tear
- Biceps tendon tear/rupture
Some common atraumatic (non-traumatic) causes of shoulder pain may include:
- Joint degenerative changes (Osteoarthritis)
- Rotator Cuff Tendinopathies (sometimes called tendinitis)
- Calcific Rotator Cuff Tendinopathy
- Frozen Shoulder (Adhesive capsulitis)
- Subacromial Bursitis
- Shoulder impingement
- Joint ligament laxity (possibly from conditions like Ehlers-Danlos)
- Joint Instability
- Anterior Instability
- Posterior Instability
- Multidirectional Instability
- Cervical Radiculopathy (see also Neck Tab)
- Thoracic Outlet Syndrome
- Peripheral Nerve-related pain
- Repetitive Strain Injury
- Swimmers Shoulder
What can I do about my shoulder pain? Tips and general Information:
- If your shoulder pain has recently increased, you can try using ice 10 minutes on, 10 minutes off, doing this 3-4 times per day as needed
- Rest your shoulder from overloading the painful structures by avoid aggravating activities (these may include overhead reaching, hands behind back or heavy lifting/carrying)
- You can try to change your sleeping position to further the resting of the shoulder (if you sleep on your back, try putting a pillow under your elbow to elevate arm slightly)
- Beginning a daily routine of gentle muscle strengthening exercises will aid in improving your shoulder health, decreasing pain and reducing the risk of reinjury
- If your shoulder pain is stopping you from doing the things you love to do, seek advice from your Physiotherapist to discuss your rehabilitation options
How can a physio help my shoulder pain?
PhysioTec is your choice for physiotherapy for shoulder pain in Brisbane. There are many potential options for management depending on your condition and your personal needs and goals. Physiotherapy for shoulder pain at PhysioTec may include:
- A thorough patient interview and physical assessment
- An evaluation of possible underlying causes, particularly important for long standing or recurrent conditions (Please book a 1 hour session)
- Education and personalised advice about how to best manage your shoulder condition and speed your recovery
- Real time ultrasound assessment and training of scapular and rotator cuff muscles
- A tailored and progressive exercise program, including video-based exercises on a free App and/or colour photographs and typed text instructions
- A gym program and a progressive return to sport plan as required
- Taping as required
1. How do I know what type of shoulder pain I have?
There are many tests that can be performed by a qualified professional to determine the likely source of shoulder pain. Occasionally imaging such as Ultrasound or Xray may be warranted.
2. How do you treat Shoulder Impingement?
Multiple methods including advice on activity modifications, postural and movement training, strengthening and hands-on treatment from a physiotherapist.
3. How can I relieve my shoulder pain?
P.O.L.I.C.E – A helpful strategy stands for ‘Protect. Optimal Load. Ice. Compress. Elevate’ however if pain persists, seek advice from a qualified professional. When sitting, place a couple of pillows under your arm/forearm to support the arm resting a little our from your side. When lying on your back, try placing a pillow under your elbow and up onto your abdomen, under your hand.
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