What Is Causing Your Shoulder Pain?
Shoulder pain is one of the most common things we treat at Glossop Physio. The shoulder is a very mobile joint so you can swing it all the way round. This mobility means your body must work hard to keep the joint stable. Like a seal balancing a ball on his nose your body must balance the ball in the socket in your shoulder by lots of tiny alterations in muscle activity. The benefit is this design is a great range of motion but this leaves a high demand on the body’s stabilizers. Several structures add stability here is a few.
Capsule/ Ligament – Fibrous tissue that surrounds the joint and doesn’t stretch it’s just like rope wire. This keeps the ball close to the socket even when your muscles are relaxed. In a dislocation it this fibrous tissue that is torn and allows the ball to slide to far and out of the socket.
Rotator Cuff – A group of small stability muscles that stabilize the ball into the socket as you move. They make frequent minor adjustments that keep the joint tracking smoothly. Like how a seal balances a ball on their nose with lots of minor adjustments, your rotator cuff makes similar adjustments to keep the ball balanced in your shoulder socket.
Scapula/Shoulder Blade – The socket is on your shoulder blade. As you move your arm especially when you lift it over head your shoulder blade should smoothly move with the ball to support it. Frequently, the shoulder blade develops a faulty movement pattern and fails to support the ball properly because it doesn’t move with the ball this can lead to pinching in the joint. Here’s an example of a shoulder blade that is not moving well.
Common Shoulder Injuries
Shoulder Dislocation
The fibrous tissue is torn allowing the ball to side out of the socket.
Rotator Cuff Injury
Partial tear or overuse injury to the stabilizing muscles of the shoulder, movement of the shoulder may pinch especially when you lift your arm to the side, it may feel as if your shoulder lacks control.
Impingement
This is when the rotator cuff tendons get pinched between the humorous and scapula. This can be caused by a muscle imbalances, tightness, weakness or poor control.
Labrum tears
The labrum is the cartilage bowl that surrounds the socket making it deeper just like the rim around a soup bowl. Any tear here can allow the ball to slide around too much in the socket and cause pain and instability.
Calcific Tendinopathy
Calcium deposits build up in the shoulders rotator cuff tendon. This limits movement and is extremely painful in any position and even with complete rest making it very difficult to sleep.
Acromioclavicular Pain (AC Joint Pain)
This is a small joint just above your shoulder where the collar bone and shoulder blade come together. It can be injured by overuse or a single even such as a fall. Press ups, dips and stretching your arm across your body tend to be very painful.
Referred Pain
Much like with an injured lower back causing sciatica down the leg, and injured neck frequently causes pain into the shoulder or arm that can feel like a shoulder injury. A neck assessment is needed to rule this out.
Their are lots of other reasons your shoulder may be painful but these are some of the common ones. Assessments to the shoulder need to focus on the physical structures and then the how the shoulder is functioning. By targeting the most significant weakness/dysfunction first our patients usually notice a great difference after just one treatment.
