THE shoulder is one of the most commonly injured joints in the body. If it weren’t for the knee, it would be THE most common.
It’s always difficult to tell because, unlike the knee which affects mobility, a damaged shoulder tends to be something we ¨put up with¨ for longer before addressing it.
This is not such a good idea! Considering the changes we’ve seen this year due to covid-19, there are even more people than usual out there nursing a shoulder that has been painful or “causing a bit of trouble”.
The common approach towards such injuries, whether it be going through a mild discomfort or trying your own exercises at the gym without following proper guidance, is liable to make the problem worse, either gradually or very suddenly and dramatically.
The joints of the body take on various forms and span a wide range of movement. The shoulder is probably the joint with the most versatile range of movement, making it more prone to injury than others.
One of its advantages in terms of mobility is its “ball and socket” structure. The “ball” is the rounded end of the humerus, the large bone of the arm above the elbow. The “socket” is a rounded bowl called the glenoid fossa carved into the shoulder blade bone (scapula to give it its scientific name). Thus, the shoulder joint is also known as the gleno-humeral joint.
The shoulder, though, is more complex than just this joint. Extra movement is afforded by the fact that the scapula itself is very mobile with only a very small articulation with the rest of the skeleton where it attaches to the collar bone (the acromioclavicular joint).
Largely, the scapula is kept in place by muscle. The four most important muscles involved in the shoulder are collectively known as the rotator cuff muscles. These provide stability between the humerus and the scapula and an injury to one of these probably accounts for the majority of shoulder injuries. You can see the four muscles in question in the diagram. They can be injured quite suddenly following trauma to the shoulder or very gradually through small strains and micro tears, often for people who have labour intensive jobs or use their arms repetitively.
The problem with leaving a mild issue is its tendency to become a major one with time and one that takes much more intervention to correct. People often only decide to do something about it when it begins to affect their sleep and by then it is much trickier to deal with. Shoulders are notoriously difficult and time-consuming to rehabilitate. Generally, if you have an injury to your rotator cuff, which could be a tear or an impingement of one of the muscles, an inflammation of the tendons connecting muscle to bone (tendonitis) or even an inflammation of the bursa that cushions the shoulder blade over the gleno-humeral joint, you might experience pain and restriction in specific movements depending on the muscle involved.
Sometimes people may experience what is called a painful arc – an ability to raise a straight arm to the side with no problems up to around 60 degrees and beyond 130 degrees but experiencing agony in between.
Generally speaking it is worth using anti-inflammatory pain killers, such as ibuprofen, as well as something like paracetamol to help with the pain in the first stages of shoulder pain. This will enable you to move that much further and indeed movement is the key.
Too much rest and it will more than likely just get worse! Exercise is the best approach but don’t go straight to the gym and bust out as many shoulder presses as you.
As soon as possible, you should seek direction from a experienced therapist but as a rule stick to exercise which encourages movement in the muscles and the strengthening should be more subtle.
Resistance/ Thera bands can help but make be sure to flex your elbow to 90 degrees to avoid putting too much strain on the shoulder. If it is really painful, only be able to walk your arm up a wall with your fingers.
The key is to avoid pushing yourself- pain is a good sign that you are doing too much. If a shoulder is painful for more than two weeks without any sign of improvement, please see out an experienced therapist to take a look.
The term frozen shoulder is often used in a variety of situations and has become somewhat of an umbrella term.
Essentially frozen shoulder is related to the gleno-humeral joint not than the muscles surrounding it. Most likely a restriction in movement will be global rather than just in certain planes.
The term adhesive capsulitis is a more specific term for frozen shoulder, essentially referring to inflammation within the joint capsule that freezes things up. Not only does this significantly restrict movement, but it can be very painful.
Generally, there are three stages to a frozen shoulder. The first is the freezing stage and this can be quite spontaneous and painful. It may last for anything from two to nine months.
Next comes the frozen stage (four to 12 months), which might be less painful although no less restrictive.
Finally, there is the thawing stage, which involves a gradual return to normality and lasts from five months to a year. Frozen shoulder is not something that goes away quickly. It is more common in long-term conditions such as diabetes as well as being more prevalent in women. In general, a steroid injection within the first six weeks might help a frozen shoulder but after that your options consist of painkillers and therapy.
If you’ve got a bit of a twinge in your shoulder, please don’t ignore it!
Pay attention to your posture — sitting slouched forward and with rolled shoulders is bad news not only for your shoulders but also for your back.
Try heat or ice on the painful areas and stay active but don’t go for your shoulder press record and if you’re worried that things are just not improving contact us to get some more focused advice.
The key here is early intervention. If you manage to nip it in the bud you may save a lot of trouble down the line 🙂