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The shoulder is a ball and socket joint that allows an abundance of varied types of movements. Unlike the hip joint, which is a very stable joint, the shoulder is more closely similar to a bowling ball on a dinner plate. While this means the shoulder has excellent movement, it also means the shoulder can become unstable joint and susceptible to injury.
Dislocations
A capsule of tough fibres surrounds the shoulder joint. If the shoulder is pushed too far in any direction it can dislocate. This means that the upper arm bone has stretched or torn through the capsule. In addition to the tearing of the capsule, dislocations can cause fractures to the shoulder socket or tears to the labrum or ligaments. The labrum is a fibrous ring of cartilage (similar to rubber) that helps make the socket deeper. Ligaments are strong fibers that help to hold the shoulder together.
Bursitis
The bursa is a fluid filled sac in the shoulder that helps reduce friction and protect the muscles from rubbing against the bones. Excessive overuse or improper conditioning can cause irritation the bursa.
Tendinosis/Impingement Syndrome
Tendons attach muscle to the bone. Overuse or improper conditioning can irritate the tendons causing tendinosis. If the situation becomes chronic the body begins to deposit calcium in the tendon. Eventually the tendon becomes pasty and will break. This is called calcific tendinosis.
Rotator Cuff Tears
There are four major muscles that attach to the shoulder joint. As a whole they are called the rotator cuff. Injury or excessive overuse can cause a tear in one or several of these muscles.
Arthritis
Another result of wear and tear is arthritis, which is breakdown or softening of the bone in the shoulder. This generally occurs on the ball and socket and sometimes at the AC joint which is the tip of the shoulder.
Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a condition that comes on slowly and the exact cause is not known at this time. The shoulder becomes painful and this leads to reduced motion. The joint capsule becomes adhered to other tissues in the shoulder joint. This leads to less range and the cycle continues until the shoulder is very stiff.
Fractures
Fractures usually occur with trauma or a fall, but as noted earlier can happen with dislocations.
Modalities such as ultrasound, electrical stimulation, heat or cold may be used to enhance healing and provide pain relief for conditions of bursitis, tendinosis, and minor rotator cuff tears. Therapeutic exercise is initiated for range of motion recovery, strengthening, conditioning and endurance. Exercise is also helpful in regaining stability in the dislocated shoulder. Manual therapy or hands on treatment may be necessary for frozen shoulder or situations where range is limited. With proper care and perseverance with therapy, many shoulder dysfunctions can be resolved. If inflammation persists, your physician may elect to inject an anti-inflammatory drug into the shoulder joint.
If rotator cuff tears, fractures, labral tears, or arthritic damage is severe enough, the shoulder may require surgery. If you have any question or concerns, consult your physiotherapist.
If you are noticing pain around the shoulder or down your arm, don’t let it get worse before doing something about it. Contact North East Physiotherapy today so that we can identify the cause of your pain and commence you on an individualised exercise program for your condition.
 See our Contact Page for booking an appointment with a physiotherapist to keep Moving You Through Life.
If you are noticing pain around the shoulder, don’t let it get worse before doing something about it. We can identify the cause of your pain and commence you on an individualised exercise program for your condition.
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