Your shoulder joint is the most mobile joint in your body. The shoulder relies on the surrounding ligaments, muscles and tendons for its function, movement and stability. Due to this, there are a number of everyday activities that may cause damage to your shoulder, resulting in pain.
Repetitive movements such as cleaning, manual labour, gardening, lifting and many sports are common causes of shoulder injuries. These activities can cause damage and inflammation, which causes pain in your shoulder.
Common symptoms may include:
- Pain around the shoulder joint
- Pain when extending arm
- Restrictive movement
- Pain when lifting the arm
- Pain when reaching behind the body
Shoulder pain can have many impacts on your lifestyle and it can be frustrating if you are seeing little or no improvement. Shoulder pain can be complex and requires a proper diagnosis to ensure the best treatment and rehabilitation is undertaken. There are many types of shoulder injuries, here are five of the most common causes of shoulder pain.
A shoulder dislocation occurs when the ball of the humerus (the shoulder joint) is forced out of the socket of the scapula (shoulder blade). The shoulder is very susceptible to dislocation due to its shallow socket which allows for such a wide range of movement. A dislocated shoulder is a severe injury and also involves other structures surrounding the shoulder, such as the ligaments. Once your shoulder has been relocated, there is still ongoing treatment and rehabilitation required to repair soft tissue damage and regain flexibility and strength.
Inside the shoulder joints are fluid-filled sacs known as bursa. The bursa helps to reduce friction between the bones in the joints and acts like a cushion. If the bursa becomes inflamed, this is known as shoulder bursitis.
Shoulder bursitis can cause significant pain and discomfort. Although the pain varies depending on the specific injury, some of the most common symptoms include:
- Pain on the top or outside of your shoulder
- Pain or discomfort when lying on your shoulderPain when opening a door
- Pain that worsens when lifting your arm
- Pain when pushing on the top of your shoulder
- Pain when you “circle” your arm
Although anyone can develop shoulder bursitis, there are some people who are more susceptible, including:
A shoulder impingement is a common cause of shoulder pain. This condition is also known as swimmers’ shoulder as it’s common in swimmers. A shoulder impingement occurs when the rotator cuff tendon and the bursa are inflamed and compressed against the bone as the arm is elevated. The most common symptom is pain with movement. However, patients often complain of loss of power and motion.
Rotator Cuff Tear
The rotator cuff is a group of four muscles that come together with tendons to form the “cuff” over the head of the upper arm bone (humerus). The rotator cuff helps to lift and rotate the arm and stabilises the ball of the shoulder joint.
A rotator cuff tear often results from an acute injury, such as a fall. However, it is also caused by normal age-related wear and tear. Usually a rotator cuff tear causes pain in the front of your shoulder which radiates down the side of your arm. The pain can be worsened by overhead activities such as reaching and lifting.
A frozen shoulder is a condition that reduces your ability to move your arm properly. This condition is characterised by pain and stiffness in the shoulder joint. Symptoms usually begin gradually and worsen over time. Those with diabetes, weakened immunity and hormonal imbalances are more prone to a frozen shoulder. Other causes include, illness, surgery and inactivity after an injury.
Shoulder Pain Physiotherapy
There are a wide range of treatments for shoulder pain. The type of treatment that is most effective will depend on your diagnosis. Some of the treatments used for shoulder pain and injuries include:
- Massage – If muscle tension or fatigue is causing your shoulder pain, massage can target muscles and help to reduce pain while increasing function.
- Manual therapy – this technique can be a powerful way to improve overall function and reduce pain.
- Taping – taping is often good to ease pain and provide support for shoulder injuries.
- Strength training – a specific program can be designed to increase strength, improve muscle tone and correct posture. This not only helps with recovery, it’s a great prevention tool for future injuries.
- Dry needling – dry needling improves muscle function and reduces pain. It helps with muscle tension and soreness, and also joint stiffness and pain.
- Post-surgery rehabilitation – following shoulder surgery, physio rehabilitation can play a crucial role in recovery.
A healthy balance between rest and exercise is often beneficial during recovery. Pacing yourself to begin with, and increasing slowly can help with your rehabilitation. You should avoid movements that are too painful and rest when necessary.
Posture is another important aspect for improving and preventing shoulder pain. Sitting in a bent forward position can make the problem worse. Sitting with a cushion behind your lower back can help to improve posture and reduce the risk of shoulder pain. Your physio will also help with posture improvement using strengthening exercises.
Is Surgery Necessary?
In some cases, surgery may be necessary for shoulder pain. However, the majority of the time, surgery may not be required even when surgery has been promoted in the past. A structured physiotherapy program is often, in the long term, much more beneficial and cost effective for effective recovery.