Shoulder pain is a common complaint we see here at FHP. The shoulder is an extremely mobile joint that we utilize every single day. Every time we reach, lift, carry, waive, shower, drive, or throw, we are using the shoulder to some capacity. If you read our article on Mobility vs. Stability, you learned that the shoulder is designed to be mobile for those above listed purposes. With that being said, there is some degree of stability that we need in the joint to ensure that injury does not occur. Let us take a look into the basic anatomy of the shoulder:
Acromioclavicular Joint (AC Joint)
Muscles & Tendons
Supraspinatus, Teres Major, Subscapularis, Biceps, Teres Minor, Triceps, Infraspinatus, Deltoid, Trapezius
What could go wrong? Hopefully, you answered a lot! In this article we are going to focus on the 3 biggest contributors to shoulder pain. Those are:
Arthritis is a condition in which you will experience pain and tenderness in the joint itself. This a slow process and does not occur over night. There are different types of arthritis (we will save that for another article) but the most common is Osteoarthritis or OA. It is typically attributed to a prior injury, or overuse of the joint. Regarding a prior injury, your body will lay down new bone over time as a protective mechanism. That mechanism is sent into overdrive when an injury occurs, and if that injury is ignored or not rehabbed correctly that new bone can turn into spurring or degeneration (picture below). Regarding overuse, the protective cartilage that is found in the joint eventually wears down resulting in a decreased joint space and “bone on bone” contact. Instead of the joint smoothly operating it becomes limited in motion and you get 2 bones in a sense grinding on each other. As arthritis progresses it can severely limit range of motion and become very painful.
Rotator Cuff Tear or Strain
The rotator cuff consists of the S.I.T.S muscle group. That stands for Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis. Each one of these muscles plays an important role in the overall function and movement of your shoulder. A tear can occur from trauma or overuse. A strain is most attributed to overuse and/or over exertion. Both will limit range of motion and cause shoulder pain during movement.
Tendinitis or Tendinopathy
As you can see from the list above there are several muscles that sit around the shoulder joint itself. Each one of those muscles has an associated tendon, and when inflamed, you get diagnosed with Tendinitis. This is most seen in individuals who overuse the shoulder. It can be somebody in the gym lifting weights and not getting the proper recovery time, or it could be an individual who lifts heavy equipment or operates with their arms overhead for most of their day. Tendinitis is the most nagging injury of the three we have listed. It is a dull, achy, and sometimes throbbing pain that requires the proper amount of recovery and therapy to heal.
As you can tell by now Overuse and Overexertion is a common theme in causing shoulder pain. When it comes to treatment and recovery for shoulder pain, we have many options available. Heat/Ice is the more generic form of treatment that will begin to alleviate your pain almost immediately. The same can be said with rest. Rest allows the body to heal and recover properly without aggravating your condition and ultimately making it worse. In some cases, manual therapy to the affected region will help increase range of motion and decrease pain. As always, a proper rehab program designed specifically for your needs will need to be constructed and followed. We will post a video with some of our favorite prehab/rehab exercises that we give to our patients that help strengthen the shoulder joint and give you that balance of mobility and stability to either prevent shoulder pain, or help rehab your shoulder back to full health.
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As always, if you are dealing with shoulder pain, give us a call and see how we can help you!
Written By: Cory S. Keesee, D.C., CSCS