Shoulder problems are extremely common. In fact, following back complaints, shoulder problems seem to be the next most common area of pain and discomfort. This is possibly due to the shoulder being a very complex joint that relies heavily on the surrounding muscles for support. A multitude of problems can occur in and around the shoulder joint. Because of this, it can be difficult to fully understand what might be causing your pain and what is the best course of action. Below is a brief description of the shoulder joint and some common complaints regularly seen in the clinic.
The Shoulder Joint is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula) and the collarbone (clavicle). Just like the hip, the shoulder is a ball and socket joint, though unlike the hip, which has a deep socket, the shoulder joint has a very shallow socket.
This shallow socket does make the joint somewhat unstable, however, it also allows the shoulder joint to have a vast range of movement. The down-side to this configuration is that the shoulder joint then depends heavily on the surrounding muscles for strength and stability.
There are several ligaments within the shoulder joint attaching the bony parts together. The joint is made a little deeper where the ball and socket meet, by ring of fibrous tissue called the ‘glenoid Labrum’. A membrane then covers the whole joint to provide further stability, as well as secreting synovial fluid which lubricates the joint. Enclosing all these structures are four deep stabilising muscles collectively known as the rotator cuff muscles. The rotator cuff muscles, along with the deltoid, latissimus-dorsi and pectoralis muscles, provide additional stability, protection and of course, movement. There are no less than eighteen muscles that directly or indirectly affect the shoulder.
One of the most common shoulder problems seen in the clinic is an impingement. This often occurs when a particular rotator cuff muscle gets pinched between the head of the humerus and the acromion process. Pain usually presents when the arm is raised sideways or twisted, resulting in weakness, restriction of movement and referred pain into the upper arm.
Impingements can happen for several reasons, such as a falling over, arthritis, or even a bony spur pushing into the muscle tendon from above. Treatment can often be quick and simple along with some postural advice, or occasionally it may require keyhole surgery.
Impingements can also be caused by a muscular imbalances and poor posture. Further to this, sports such as swimming, tennis, badminton and gymnastics can all contribute to an impingement injury. Occupations such as painters, decorators and plasterers also provide their fair share of impingement problems due to the position of the shoulder when working.
Frozen shoulder: Medically referred to as ‘adhesive capsulitis’, frozen shoulder is a disorder in which the capsule surrounding the joint becomes painful and greatly restricted. This condition typically affects people between 40-60 years of age and generally lasts between 18-24 months. Frozen shoulder seems to be more common in females, often occurs after an injury and seems more prevalent in certain conditions such as diabetes, overactive thyroid and Parkinson’s disease.
Recovery is often slow and frustrating, but over time, progress can be made. It is important to keep exercising the shoulder as much as possible as this may affect the overall outcome in terms of mobility.
The Acromio-Clavicular (AC) Joint: The (AC) Joint is found where your collar bone (clavicle) meets the shoulder at the acromion. This joint is often problematic following a fall or trauma such as a traffic accident where the seatbelt forces the clavicle backwards. Excessive loads, such as bench pressing in the gym, or repetitive pushing movements can also irritate this joint. Pain can often be resolved quickly with minimal treatment and rest, although occasionally an operation is needed if the joint completely dislocates.
Other causes of shoulder pain include: dislocation, muscular strain, ligament sprain, bursitis, arthritis, fracture, labral tear or referred pain from the neck. Non-mechanical pain includes: polymyalgia, infection, cancer and referred pain from the heart, liver, gall bladder, stomach or pancreas.
Stay Injury Free: Exercise is important to keep the ‘tone’ of the muscles. Without good support from the muscles the shoulder can become unstable and vulnerable to dysfunction. If you weight train regularly, it is very important to balance your workouts properly and be aware of your posture! Avoid slouching wherever possible, both at work and at home when sat at the table or watching T.V. Sportspeople who are involved in activities that require large shoulder movements such as golf or tennis, should also have their technique checked occasionally to help avoid injury and optimize performance.
How an Osteopath can help:
An osteopath should be able to examine your shoulder and identify the root cause of the pain or discomfort. Osteopaths can often help relieve pain through manipulation and other treatments modes such as TENS or acupuncture. Further to this, osteopaths should also advise on exercise, posture or other issues which could improve your condition; or refer to your GP if necessary.
“Take care of your body; it’s the only place you have to live.” – Jim Robin
For more information visit: www.jhoughtonosteopath.co.uk or contact Jason at: firstname.lastname@example.org or Tel: 01603 291925. M: 07736 449603. Thank you for reading.