Shoulder pain is a clinical interest of mine and I treat a wide variety of problems causing pain. Here is an overview of the shoulder with 5 common causes of shoulder pain seen in the clinic.
The shoulder is a complex joint that has many moving parts which can be subject to injury and pain. We use our arms all day everyday for a wide range of different activities from lifting to throwing, from driving cars to picking up our children. Ligaments, tendons and muscles support a very mobile ball and socket joint. Any of these structures can become injured or painful, from an acute injury, for example a fall or gym strain to repetitive stress such as an overhead work activity. This can start a cascade of inflammatory events resulting in pain, weakness, muscle spasm and loss of range of motion which limit your function of normal activities of daily living.
5 Common Causes
1. Shoulder impingement
In our shoulder we have a bony tunnel created between the AC joint (end of our collarbone) and the shoulder joint below. Through here runs a rotator cuff tendon and a bursa (fluid filled sac that prevents frictional rubbing between bone and tendon). With acute injury, such as a fall or a sudden jar at an awkward angle, this tunnel can be pinched or jammed up. With repetitive overuse in awkward angles, the contents of the tunnel can get inflamed and therefore thicken. Both presentations will cause narrowing of the tunnel and compression of the tendon and bursa, causing pain and restriction and what is known as shoulder impingement.
2. Rotator cuff sprain or tear
Your rotator cuff is comprised of four muscles, and it enables you to lift and rotate your arm. It also serves to stabilise the ball of the shoulder joint. With injury, there is potential for a rotator cuff sprain or tear. This can also occur in older people due to the natural ageing process. Pain is typically felt at the front or side of the shoulder and may radiate down the arm. This injury can make it difficult to reach up or lift objects due to pain.
3. AC joint pain
The AC joint is located on top of our shoulders and is the connection between the end of our shoulder and collarbone. The most common causes of these injuries are falls or repetitive movements across the front of your body, for example painting, or bench pressing in the gym. These movements all compress the ACJ, causing irritation, inflammation and therefore subsequent pain.
4. Frozen shoulder
Frozen shoulder or adhesive capsulitis, is a very unfortunate presentation where the capsule of connective tissue surrounding the ball and socket joint gets inflamed and causes severe movement restriction at the shoulder. People suffering from frozen shoulder usually cannot lift their arm above their head or behind their back, and when they do lift their arm, the whole shoulder complex will look stiff and move as one. There remains no known cause to how and why this happens, but research has shown that it more commonly affects middle age woman, diabetes sufferers and more so occurs following an injury that has led to reduced movement at the shoulder.
5. Injury to the Labrum
A Labral tear can happen over time from continuous overhead motions or a fall. Athletes can often develop this tear from throwing a ball, playing tennis, or swimming. The tear affects the rim of cartilage around the shoulder socket and causes an achy feeling that is hard often to pinpoint.
How I can help
If left untreated, shoulder injuries can cause long term complications. On your first visit i'll perform a thorough initial assessment so that I can confirm your diagnosis, provide education and answer any questions you have. I can lodge your ACC claim and order imaging if needed. From there I can devise an individualised treatment plan to relieve your current symptoms, and a long term plan to prevent future reoccurrences. If further help is needed, I can order specialist referral.
Common shoulder Physio treatments include diagnosis, education and advice followed by massage and trigger point work to calm down symptoms. Once things have calmed down we can start some rehabilitation either one on one in the clinic gym or through an online exercise program.
If you are suffering from shoulder pain, get in touch today!