Shoulder Pain & Injuries
Many of us suffer some from some form of shoulder pain in our lives, often it comes and goes without much significance but there are times that it can really affect your day to day living. Shoulder pain can be either acute or chronic depending on how long you have had the pain for. An acute shoulder injury will occur suddenly, this is usually through either a direct impact, an over-stretching or overuse of a muscle, tendon or ligament, or from a twisting action of the shoulder joint. The most common causes of shoulder pain include:
- Shoulder dislocation
- AC joint injury
- Rotator cuff tears
- Labral tear
- Frozen shoulder
This is a very painful and traumatic injury that is often caused in contact sports or a fall onto an outstretched arm. The shoulder joint is very prone to injury due to the large range of mobility available which in turn sacrifices its stability. Shoulder dislocations occur when the head of the humerus bone pops out of the shoulder socket. It can pop out in either a posterior, inferior or anterior position (95% of all dislocations) and in the process will cause damage to the surrounding soft tissue structures such as the muscles, tendons and ligaments. The individual will often feel a pop and see a difference between sides.
Immediate treatment needs to firstly protect the shoulder joint and prevent further damage and secondly to seek medical attention as soon as possible. Once the shoulder has been relocated then it is very important to commence a graduated rehabilitation program in order to get you back doing what you love most.
AC Joint injury
An AC joint sprain or separation involves injury to the ligament that holds the acromioclavicular joint together at the top of the shoulder. The AC joint is formed by the outer end of the clavicle/collar bone and the acromion process of the scapular/shoulder blade. Most often injury to the AC joint occurs when falling onto an outstretched arm. Symptoms will include pain at the end of the collar bone on the top of the shoulder and a loss in range of movement due to pain.
Early treatment is essential to avoid any long term complications or issues. Management is usually conservative and involves general soft tissue work, taping and strengthening.
A bursa is a small fluid filled sac that helps to lubricate a moving tendon. The bursa that lies on top of the supraspinatus tendon in the shoulder can become trapped causing pain and inflammation. This is more common in individuals that have their arms at or above shoulder level.
The aim of treatment is to reduce pain and inflammation and to correct an abnormal movement patterns reducing the risk of the pain returning.
Impingement syndrome in itself is not a diagnosis, it is a clinical sign. Impingement is where soft tissues become impinged/caught as they pass through the narrow bony space under the arch of the acromion, this space is called the subacromial space. With repetitive pinching, the tissues can become inflamed and irritated. There are lot of injuries that can lead to or cause impingement, these include injury to the rotator cuff, labrum, shoulder instability, biceps tendinopathy, bursitis or scapula dysfunction.
Shoulder impingement is classified as either internal or external depending on the causes. External impingement is further classified into primary (caused by bony spur or a direct cause) and secondary which occurs due to poor stabilisation of the shoulder joint.
Treatment is aim at reducing the pain and inflammation, improving mobility and strength whilst correcting any mechanical dysfunction to ensure that it doesn’t reoccur.
Rotator cuff tear
It is important to know that there are 4 muscles that make up the rotator cuff and they work together to provide the joint with dynamic stability. The rotator cuff muscles consist of the supraspinatus, infraspinatus, teres minor and subscapularis muscles. The supraspinatus and infraspinatus are the most commonly injured particularly in sports which involve a lot of shoulder rotation, such as cricket bowlers, pitchers in baseball and swimming. This injury can also be seen in the older athlete especially where long term overuse or degeneration is present.
A tear in the rotator cuff is usually caused by an overstretching or a rapid twisting movement of the joint and symptoms can consist of:
- Sudden pain
- Possible referral down side of arm (deltoid region)
- Impingement (tendon can get pinched between ball and socket)
- Reduced range of movement
- Painful arc of movement
Treatment is aimed at reducing the pain and inflammation, regaining full movement and strength and getting you back to your chosen activity.
Get in touch to see how the expert Physiotherapists at Powerhouse can help with your shoulder injuries and pain.