Shoulder Pain


Shoulder Pain

The shoulder is a pretty complex region of the body when it comes to its anatomy and what’s involved in helping us move. The connection between the arm bone (humerus), collar bone (clavicle), the shoulder blade (scapula) and the rib cage provide us with the ability for our limb to move through an extremely wide range of motions. In fact, the shoulder has the most movement out of any joint in the body!

Because of this ability to have such a large range of motion, it does mean that the shoulder is less stable, therefore it means there is a higher possibility of injuries occurring to this region. And one of the first questions as a Physio that we constantly get asked is, ‘How long will it take to get better?’ And while this is a very reasonable question to ask, the answer is never plain and simple.

The answer will not only differ depending on the various injuries that present, such as Rotator Cuff Related Pain, or Subacromial Pain Syndrome to name a couple, but also on the individual's biological, psychological and social factors.

So what are the injuries suggested above?

Rotator Cuff Related Pain

Rotator cuff related pain is a term used to describe a cluster of rotator cuff injuries that the pathology points to either rotator cuff tendinopathy or tendinitis, or partial or full thickness tears of the rotator cuff.

The rotator cuff is a group of muscles that hold the upper arm bone into the socket of the shoulder and due to such an important job, can be prone to injury.

Some symptoms that you may experience include:

  • Dull achy pain
  • Weakness
  • Reduced range of movement

These injuries are one’s that can increase in frequency and intensity as we age.

Subacromial Pain Syndrome

Subacromial pain syndrome describes the pain felt in the subacromial space of the shoulder. This is the space between the arm bone and a bony prominence off the shoulder blade that sits over the top (called an acromion). Some tendons of the arm muscles pass through this space, as well as a ‘bursa’ that sits in there. A bursa is a small sack of fluid that sits in the joint space to help keep movements nice and fluid.

Due to having quite a lot of tissues all crammed into a small space, sometimes an impingement can develop.

Common causes of an impingement can include:

  • Repetitive overhead movements
  • Longstanding poor movement patterns
  • Deconditioned or weak shoulders
  • Heavy lifting

Did you know that more often than not, a sore shoulder presenting with subacromial pain syndrome is actually weak and can’t handle the specific load being thrown at it and the surrounding tissues resulting in irritation and inflammation.

Inflammation can lead to the swelling of these tissues in the subacromial space and then when we move our arm up or out to the side, we are effectively pinching these structures. Often, there is more than one tissue or structure responsible for the inflammation.

Recent research now suggests that the lack of subacromial space is actually a result of physical deconditioning, reduced strength and resilience of the rotator cuff which causes the humeral head to migrate into the socket hence reducing the amount of space available for everything to move.

Accurate assessment and tailored rehabilitation of your shoulder injury or pain is critical to avoid ongoing issues in future. Rehabilitation will often involve a combination of manual mobilisations, soft tissue release, proprioception retraining, strengthening and stretching in order to improve the mobility, strength and stability in and around the shoulder.

If you have recently injured your shoulder or have an ongoing chronic ‘dodgy’ shoulder that limits you from doing everything that you love, don’t hesitate to contact our friendly admin team and they will be able to book you in with one of our experienced physios.

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