The shoulder joint is a synovial, ball and socket joint, made up of the humerus, shoulder blade and clavicle. It also has a close relationship with the rib cage. The ‘ball’ (the end of your humerus) sits in the ‘socket’ (a shallow socket on the side of your shoulder blade) much like a golf ball within a tee. This construction allows for a lot of movement so that we can reach high and perform all the activities we need to. This joint probably evolved this way so our predecessors could swing from tree to tree!
The mobility of the shoulder means that a lot of structures are involved in maintaining its stability including ligaments, tendons, muscles and connective tissue. Tendons blend around the joint to form the supportive rotator cuff and control movement of the humerus in the shoulder joint. These tendons pass under the acromion – a process of the scapula. This is a common area that produces pain as many activities and poor posture closes the gap between the bony process and the tendons underneath causing friction and inflammation to the tendons.
Shoulder pain is often caused by poor posture and repetitive use injuries. The most common conditions include shoulder impingement syndrome, tendinopathy, bursitis, frozen shoulder, shoulder instability and arthritis. Problems with the function of the scapula can also cause problems.
People with shoulder problems often experience pain and tenderness around the shoulder joint and in the upper arm. Problems in the neck can cause referred pain to the shoulder and arm. Other symptoms can include aching, clicking, weakness, shooting pains and referred pain down the arm. Symptoms often get worse with overhead activities, carrying, lifting and prolonged poor postures.
Physiotherapists are highly skilled in the assessment and management of shoulder pain. A detailed assessment of your shoulder will identify the factors causing your shoulder pain and from this your Physiotherapist will create an individualised treatment plan to get you on the road to recovery. Your Physiotherapist may identify problem areas in parts of your body other than your shoulder, for example postural abnormalities in any part of your body can lead to shoulder pain and problems within your neck can cause referred pain to your shoulder. Management of all identified problematic areas will be incorporated into your treatment plan.
Your treatment plan will likely include an exercise program to target the specific problem areas as Physiotherapists are highly skilled in exercise prescription. Your exercise program may include stretching, strengthening, balance and postural exercises. Other treatments that may be used include soft tissue work, mobilisations, electrotherapy, heat and cold therapy, kinesiology taping, strapping, relaxation techniques, advice and education. Physiotherapists can also provide rehabilitation programs following surgery to the shoulder.
Depending on your condition your pain should improve within just a few Physiotherapy sessions. However, continued support is available to prevent further injury and for those of you who need to improve your sport performance or daily activities. Conditions such as frozen shoulder, impingement and shoulder instability require a specific progression of exercises so it is important that you follow the advice of your Physiotherapist to prevent further pain and dysfunction. Your Physiotherapist can help design your exercise program that is specific and relevant to your needs.
Other services that are available at Estuary Clinic to help in the management of your shoulder pain include: