The shoulder is a ball-and-socket joint that allows for an abundance of varied types of movements. Unlike the hip joint, which is a very stable joint, the shoulder is more closely similar to a bowling ball on a dinner plate. This means that while shoulder has excellent movement, it also can become unstable and susceptible to injury.
The shoulder joint is surrounded by a capsule of tough fibers. If the shoulder is pushed too far in any direction, it can dislocate, which means that the upper arm bone has stretched or torn through the capsule. In addition to tearing the capsule, dislocations can cause fractures to the shoulder socket or tears to the labrum or ligaments. The labrum is a fibrous ring of cartilage (similar to rubber) that helps make the socket deeper. Ligaments are strong fibers that help to hold the shoulder together.
The bursa is a fluid-filled sac in the shoulder that helps reduce friction and protect the muscles from rubbing against the bones. Excessive overuse or improper conditioning can cause irritation the bursa.
Tendons attach muscle to the bone. Overuse or improper conditioning can irritate the tendons, causing tendonitis. If the situation becomes chronic, the body begins to deposit calcium in the tendon. Eventually the tendon becomes pasty and will break. This is called calcific tendonitis.
Rotator Cuff Tears
There are four major muscles that attach to the shoulder joint. They are referred to together as the rotator cuff. Injury or excessive overuse can cause a tear in one or several of these muscles.
Another result of wear and tear is arthritis, which is the breakdown or softening of the bone in the shoulder. This generally occurs on the ball and socket and sometimes at the AC joint, which is the “tip” or “point” of the shoulder.
Adhesive capsulitis or “frozen shoulder” is a condition that comes on slowly. The exact cause is not known at this time. The shoulder becomes painful, leading to reduced motion. The joint capsule becomes adhered to other tissues in the shoulder joint, which leads to less range, and the cycle continues until there is no motion left in the shoulder.
Fractures usually occur with trauma or a fall, but as noted earlier, can happen with dislocations as well.
Shoulder problems are one of the most common areas of pain we treat at Fine Form Physiotherapy. Most patients achieve excellent results, however there are some that have severe damage and require either a cortisone injection or surgical repair.
Treatment will usually involve:
- Massage therapy and joint mobilisations to improve range of movement and reduce muscle tightness
- Modalities such as ultrasound, electrical stimulation, heat and cold to enhance healing and provide pain relief for conditions of bursitis, tendonitis, and minor rotator-cuff tears.
- Rotator cuff strengthening exercises with theraband for range-of-motion recovery, strengthening, conditioning and endurance.
- Exercise is also helpful for regaining stability in the dislocated shoulder.
With proper care and perseverance with therapy, many shoulder dysfunctions can be resolved. Rest from aggravating activities usually plays a critical role in the management of most shoulder conditions.
Many shoulder problems if left untreated will develop into chronic conditions and develop increased amounts of scar tissue. It is critical you get your sore shoulder looked at early to prevent further damage to the joint. Call our clinic to make an appointment and have your shoulder looked at by an expert you can trust to get you back in Fine Form.