Shoulder

Explanation:

The shoulder or glenohumeral joint is a “ball and socket” joint. The bony structure of the joint surfaces, the ligaments, capsule and muscles are all key components in maintaining a stable shoulder joint yet permitting a large range of movement in several directions.

Causes:

There are many conditions that can result in shoulder pain including:

subluxations
fractures
tears in the rotator cuff muscles (muscles around your shoulder that maintain it in good position) or the labrum (a ring of fibrous tissue that surrounds the socket to make it deeper and provide more stability in your shoulder) through an injury
shoulder instability (see below)
referred pain from the cervical and upper thoracic spine

The more insidious shoulder pathologies are usually frozen shoulder and impingement syndrome.

Shoulder impingement occurs when the rotator cuff tendons become trapped in the shoulder joint. It is often posture-related or due to an imbalance of the muscles around the shoulder. The impingement causes mechanical irritation of the rotator cuff tendons and may result in swelling and damage to the tendons.

A frozen shoulder (known also as adhesive capsulitis) is a condition that occasionally occurs in older athletes or people between 40-60 years old. The medical term literally describes what is seen in this condition – adhesive meaning sticky, and capsulitis meaning inflammation of the joint capsule, making the joint stiff and difficult to move.

Other causes of shoulder pain are shoulder instability and referred pain from the cervical and upper thoracic spine. Shoulder instability is a problem of a loose shoulder joint. Instability is often associated with subluxation (partial dislocation of the shoulder joint), which may be associated with pain and/or dead arm sensation. Shoulders dislocate relatively easily, so once the dislocation is treated it is important to get all the muscles back in good working order. Patients who have sustained a prior shoulder dislocation often develop chronic instability.

Treatment:

Our physios will examine your shoulder and use a broad range of treatments including:

joint mobilisation
passive stretches
correction of faulty techniques when moving the arm
trigger pointing and/or acupuncture
soft tissue techniques to alleviate pain and increase range of movement.
education on your condition, postural advice, and strengthening exercise programmes to strengthen your shoulder and increase stability.