Shoulder Pain

Are you having shoulder pain? Is shoulder pain bothering at night?  Is it difficult for you to perform your daily activities due to shoulder pain?

Structures that make up shoulder joint

  • Sternum
  • Clavicle
  • Ribs
  • Scapula
  • Humerus

 

Anterior view of shoulder joint with muscles.

Shoulder pain can occur from X number of factor.

  • Sprains and Strains
  • Rotator cuff injury
  • Tendon rupture
  • Torn Ligament
  • Osteoarthritis of shoulder joint
  • Impingement
  • Thoracic Outlet syndrome
  • Bursitis
  • Frozen shoulder/ Adhesive Capsulitis
  • Overuse
  • Repetitive overhead movements
  • Dislocated shoulder.
  • Poor posture.
  • The list goes on.

With detailed history our therapist will pin point the cause and try to alleviate the pain.

Shoulder Pain can occur due to various injuries or disease of your shoulder joint.  Injuries can be related to ligaments, tendons, cartilage, menisci, bones or bursae surrounding your shoulder joint.  Humeral head is larger than glenoid fossa of scapula making it very unstable joint.  Due to shoulder joints instability it has greater mobility.  This makes the joint high risk for injury.

Also pain can occur from diseases or condition involving shoulder joint, such as arthritis, frozen shoulder, damage to the nerve supply.  Sometimes heart attack can radiate pain to shoulder and neck.  Please be advised and if that is the case go to emergency room.  

Poor posture and repetitive over head activity you can irritate nerve supplying your shoulder joint resulting in thoracic outlet syndrome.

What a lot of people miss is your scapula dysfunction (shoulder blade).  Scapula plays a vital role in shoulder range of motion.  It is known as Scapulohumeral rhythm.  1/3 of your shoulder motion occurs at scapulothoracic joint (shoulder blade and rib cage) when elevating your shoulder overhead, and 2/3 of your shoulder range of motion occurs at glenohumeral joint.

Scapulothoracic joint motion is allowed with motion of acromioclavicular and sternoclavicular joint, and it comes in play during end range of motion, when pain occurs at end range more focus should be given to scapula in order to see any dysfunctions are present.

Sternoclavicular joint: Is a saddle joint.  Absorbs upper extremity force.  It Elevates during shoulder flexion and abduction and depression during shoulder extension and adduction.  Protractions during shoulder horizontal adduction and retractions during shoulder horizontal abduction and shoulder extension.  This joint comes in play after 90 degree of humeral movement, if there is no posterior rotation humeral elevation is limited to 120 degrees.

Acromioclavicular joint aka AC Joint.  It helps with movement of scapula resulting in end range of motion.

Some TIPS to help with pain.

Improve posture, not sticking your chest out too much or hunched forward.  You want to seat in a neutral position.

Stretching:  Stretching is important to restore your range of motion.  Target muscles surrounding shoulder joint.

  • Deltoid (anteior, middle, and posterior)
      Deltoid stretch
  • Biceps
  • Tricpes
  • Rotator cuff ( supraspinatus, Infraspinatus, teres minor, and subscapularis)
  • Pectorals
  • Rhomboids

    Infraspinatus, Teres Minor stretch
  • Trapezius

    Tricep stretch
Bicep stretch
Pectoral stretch
supraspinatus stretch
Gentle strengthening exercise within pain free ROM.  While strengthening make sure to correct posture.

 

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