Shoulder Pain

What causes shoulder pain?

Explaining the shoulder joint and muscles of the shoulder.

Three bones make up the shoulder joint: humerus, scapula, and clavicle.
The shoulder has 2 distinct joints – called the  ‘shoulder complex’

Shoulder girdle is formed by the sternum, clavicle and scapula.
Glenohumeral joint formed between the scapula (glenoid cavity) and head of humorous.

The shoulder girdle enables the scapula to glide across the thorax Movements of the shoulder girdle:

Elevation
Depression Protraction
Retraction

ROTATOR CUFF MUSCLES

4 MUSCLES:
SUPRASPINATUS: Holds your humerus in place and keeps your upper arm stable.
INFRASPINATUS: The main muscle that lets you rotate and extend your shoulder.
TERES MINOR: The smallest rotator cuff muscle.
SUBSCAPULARIS:  Holds your upper arm bone to your shoulder blade and helps you rotate your arm, hold it straight out and lower it.

The rotator cuff muscles help stabilize the shoulder joint and facilitate various movements of the arm.
These muscles enable us to move our holds and arms.
Elevation, depression, protraction and retraction.

This enables the arms to: Flexion, extension, abduction, adduction, internal rotation, external rotation, horizontal flexion, horizontal extension

What causes shoulder problems?

• Daily wear and tear can cause injuries to the rotator cuff muscles.
• Sporting activities:  tennis, throwing or similar.
• Job:  painters, Repitive tasks, or use of the shoulders.
• Irritation of the tendons and ligaments through Repitive work, overload or injury.
• More common aged 30 plus.
• If left untreated can become serious.
  
  Treatment: manual therapy, strengthening exercises, rest and ice if an injury.  If no improvement refer to GP or specialist.

SHOULDER IMPINGEMENT:

WHAT ARE THE SYMPTOMS OF SHOULDER IMPINGEMENT?

Commonly rotator cuff impingement has the following symptoms:

• An arc of shoulder pain approximately when your arm is at shoulder height and/ or when your arm is overhead.
• Shoulder pain that can extend from the top of the shoulder down the arm to the elbow.
• Pain when lying on the sore shoulder, night pain and disturbed sleep.
• Shoulder pain at rest as your condition worsens.
• Muscle weakness or pain when attempting to reach or lift.
• Pain when putting your hand behind your back or head.
• Pain reaching for the seat-belt, or out of the car window for a parking ticket.

There are  different stages  to shoulder rehabilitation.

• Early Injury: Protection, Pain Relief & Anti-inflammatory Treatment.
• Regain Full Shoulder Range of Motion.
• Restore Scapular Control and Scapulohumeral Rhythm.
• Restore Normal Neck-Scapulor-Thoracic- Shoulder Function, including posture correction.
• Restore Rotator Cuff Strength.
• Restore High Speed, Power, Proprioception and Agility Exercises.
• Return to Sport or Work.

Is quite a common condition, where a tendon rubs or catches on the bone or tissue as your lift your arm.  This tendon connects the muscles around your shoulder to the joint on the top of your arm.

Manual Therapy, shoulder exercises, ice packs and painkillers can help with shoulder impingement.

It can be caused by over use of the shoulder or injury.  Age can also be a factor due to wear and tear

REHABILITATION

Stage 1

• Mobility and pain reduction
• Soft tissue work
• Mobility exercises
•  Hot/ Cold therapy

Move onto Stage 2 when no pain at rest,

• exercises elicit no more than a 4/10 pain
• Stage 2 Soft tissue work Improve ROM
• Isometric Strength through all ranges

Move onto Stage 3 when all exercises elicit no more than a 4/10 pain

Stage 3 Concentric/ Eccentric strength and return to sport Prevent relapse