April 8th, 2020
The shoulder is one of the more complex joints in the human body. The main players include the:
- Glenohumeral Joint: the joint formed by the upper arm bone and shoulder blade
- Labrum: the cartilage that helps support the glenohumeral joint
- Rotator Cuff: a series of 4 muscles that hold the glenohumeral joint in place
- AC Joint: the joint formed between the collarbone and shoulder blade
Any one or combination of these structures can be a source of irritation when someone has shoulder pain. Lending to its complexity, there are other areas of the body that can influence the shoulder causing or contributing to shoulder pain.
- Neck: problems in the neck such as a pinched nerve can refer pain to the shoulder.
- Upper Back: lacking mobility in the upper back is a common contributor to shoulder pain.
- Core: lacking core stability can cause excessive stress to be placed on the shoulder especially during athletic tasks.
Determining where the pain is coming from in the shoulder is only half of the battle.¬† It‚Äôs equally as important to figure out why the pain is there in the first place.
Some common painful shoulder conditions include:
AC Joint Sprain
An AC joint sprain is a very common sports injury. It usually occurs due to a fall on the shoulder or an outstretched hand injuring a ligament that supports the joint.¬† Significant tears in that ligament can allow your collarbone to move upward, out of its normal position, creating a raised bump under your skin. Most AC joint sprains are best managed conservatively with a combination of chiropractic and corrective exercise.
Rotator Cuff Injury
Rotator Cuff Injuries can include tendinopathies, strains, and tears. The majority of rotator cuff injuries are due to repeated stress and overuse, while a small percentage result from a slip or fall.¬† Symptoms of a rotator cuff injury can include pain on the outside portion of the shoulder, shoulder weakness, pain that‚Äôs worse at night, and difficulty raising the arm overhead.
Young patients who have suffered an acute tear or rupture may require surgery, while most others will benefit from conservative treatments, like the type provided in this office. Be sure to avoid painful overhead activity or carrying heavy objects. Try not to sleep on your irritated side, especially with your arm stretched overhead. You may benefit by sleeping on your unaffected side with a pillow between your arm and trunk.
There are several types of Labrum Tears, but the most common is called a SLAP lesion. Trauma, like a fall onto an outstretched arm or a direct blow to the shoulder, is responsible for approximately 1/3 of all SLAP tears. Other tears develop more slowly from repetitive strain. SLAP injuries are common in athletes, particularly throwers. Symptoms from SLAP tears can vary from unnoticeable to disabling. Complaints often include a deep, vague non-specific shoulder pain that is provoked by reaching overhead or moving your arm across your body.
Although non-surgical treatment of SLAP tears is not always successful, most experts, including the American Academy of Orthopedic Surgeons, recommends trying conservative care prior to considering surgery. Your initial treatment will focus on reducing inflammation. You should avoid activities that cause pain, particularly throwing. As your symptoms improve, you will be taught progressively more challenging exercises to help you recover. Unfortunately, SLAP tears recover slowly and some cases will require surgical repair.
Impingement is the most common shoulder disorder and accounts for about half of all shoulder complaints seen by physicians. Those who perform repetitive overhead activity are at greater risk for impingement. This includes athletes who participate in: swimming, baseball, volleyball, weightlifting and tennis as well as jobs like: carpenters, electricians, painters and wall paper hangers.
Impingement often starts after a period of overuse. Initially, your symptoms may be limited to a sharp pain during overhead activity or while reaching behind the back to fasten a bra or close a zipper. As your condition progresses, you may develop a constant ache that is present even at rest. Nighttime pain is common, often disrupting sleep.
This issue is RARELY requires surgery. Treatment involves limiting the painful movements while building strength and flexibility around the shoulder. A skilled therapist will guide you through an easy progression back to once painful movements.