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The Fantastic Shoulder Joint

Shoulder joints are amazing joints. They allow us to do so much from reaching up to the biscuits on the top shelf to extracting our wallet from our back pocket. Without the incredible mobility of the shoulder joint we would not be able to do so much with our hands, making life difficult.
However, we tend not to appreciate just how good our shoulders are until they develop problems. Shoulder pain is a common complaint with about 10% of people developing shoulder pain during their lifetime. Let's look at the wonderful shoulder joint, what may go wrong, and what can be done to help shoulder pain.
What Makes Up The Shoulder?
The shoulder is the ball and socket joint between the head of the humerus (arm bone) and the glenoid part of the shoulder blade (scapula) which is why the shoulder is also called the gleno-humeral joint.image
The joint is surrounded by a tough fibrous sleeve, called the capsule, which contains fluid to nourish and lubricate the joint. A group of tendons, known as the Rotator Cuff, then make up a cloak around the capsule and they help to both move the joint and hold it together. Between the rotator cuff tendons and the bony Acromion lies a bursa - a fluid filled sack which cushions the cuff and prevents it rubbing on bone.
What Can Cause Shoulder Pain?
Not every pain felt in the shoulder is coming from the shoulder. Problems with your neck can cause pain in your shoulder and this is known as referred pain. Pain from the shoulder joint is often felt over the front of the shoulder or in the upper arm and can be due to:-
  • Inflammation of the bursa, known as subachromial bursitis.
  • Inflammation or damage to the rotator cuff tendons - tendonitis or a small tear.
  • Muscle weakness or imbalance causing poor control of movements and pain.
  • Inflammation of the capsule - also known as "Frozen Shoulder".
What Can I Do To Help?
Unless you have a definite injury or the pain is extremely bad you do not need to see a doctor straight away. Simple measures such as appropriate medication from your local Pharmacist to help with pain, relative rest and the use of ice can all help. Relative rest means that you should aim to use your arm as normally as possible so that the shoulder does not become stiff, but avoid the positions and activities that increase pain.
If symptoms do not improve quickly or if you have any specific concerns, consult your doctor or Chartered Physiotherapist for advice. After an assessment, they will be able to give you an accurate diagnosis.
Can Physiotherapy Help?
Yes! The vast majority of shoulder problems will benefit from Physiotherapy. Your Physio will perform a detailed assessment of your condition and then put together a treatment programme tailored to your needs.
Most people will benefit from a home exercise programme to ease stiffness, to strengthen weak muscles and to improve posture. Electrotherapy techniques such as ultrasound may be used to help pain and promote recovery. Manual techniques such as massage and mobilisations may be used to stretch tight structures. Research shows that people who work hard to keep muscles strong and maintain shoulder movements make a quicker and more complete recovery.

If you do not progress as expected with Physio, your therapist may refer you back to your doctor to consider whether a steroid injection would be of benefit, particularly if you have a lot of pain at night. Rarely, you may be referred on to an Orthopaedic Surgeon for further investigation. The shoulder is a fantastically mobile joint which allows us to do many things. Do not despair if it becomes painful - there is a lot that can be done to help.

This article was written by the McNaughton Physiogrange Team and first appeared in the March 2010 edition of the 702 Gazette

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