Shoulder Pain and Common Shoulder Problems
Posted February 27, 2023
Shoulder Pain and Common Shoulder Problems
Common Causes of Shoulder Pain
The shoulder is one of the most mobile joints in the human body. Our shoulders allow us to complete so many tasks – pitching a softball, swinging a golf club, and reaching to put objects in high cabinets. This great range of use and mobility does come with complications, though. When joints can move in various directions, they generally have less stability than other joints. For example, elbows bend and straighten and are comprised directly of the radius, ulna, and humerus, or the bones that make up the span of the arm. This bone connection creates great stability, leaving the elbow at much less risk for injuries that the shoulder is more predisposed to.
The shoulder is incredibly complicated and intricately balanced by four joints, eight muscles, four major ligaments, and several tendons. Shoulder pain causes fall into a few distinct categories: tendon-related, degenerative, fractures, and instability.
Tendon-Related
Every muscle that comprises the shoulder has tendons that may become injured or irritated and cause shoulder discomfort. You have likely heard of a rotator cuff tear or rotator cuff strain. These are either complete or partial muscle and tendon tears and typically happen from falls directly on the shoulder or with the arm outstretched or from overuse. Tendonitis, such as rotator cuff tendonitis or biceps tendonitis happens due to overuse and poor movement patterns, which create pain and inflammation.
Degenerative
Shoulder joint or muscle degeneration can also create shoulder pain. Shoulder osteoarthritis is the leading reason for shoulder joint replacements. In addition, as we age and as we are sedentary, our joints and muscles can become stiff and painful. This reduces the range of motion in the shoulder and creates an imbalance within the muscles, joints, and ligaments, causing dysfunction.
Fractures
A major cause of shoulder pain is fractures or broken bones. Many sports injuries and falls involve shoulder fractures, including the humerus (bone in the upper arm), the scapulae (shoulder blade), and the clavicle (collar bone). Many people will need surgery to stabilize a fracture and adequate healing time.
Instability
Shoulder instability happens for a variety of causes, mostly due to the intricate balance the muscles, tendons, and joints create. Shoulder dislocation happens when the top of the humerus (upper arm bone) disconnects from the socket. This can be caused by trauma such as a car accident, or gradually over time from ligament damage and overuse. Shoulder instability can cause problems like impingement and labral tears. Impingement creates pinching of either the front or the back of the shoulder socket from repeated poor movement patterns. Labral tears can happen over time with poor movement patterns, or suddenly from a fall or accident, and people are more at risk of this if their shoulder was unstable before the accident.
Although there are numerous causes of shoulder problems, physical therapy for shoulder pain is one of the most effective treatments.
When You Should Seek Help
Shoulder pain can be acute or chronic caused by an injury or happen from gradual wear and tear over time. No matter the cause, shoulder pain will generally improve more quickly the earlier it is treated. Physical therapy exercises for shoulder pain can begin immediately after any injury or surgery, with simple movements to enhance early recovery. If you have had shoulder pain for months to years and have not had physical therapy yet, you should still make an appointment. Physical therapists will help improve the pain, mobility, and use of your shoulder no matter how long you have had shoulder pain.
Serious indicators for immediate medical care for the shoulder include:
– Severe pain that is not improving with rest
– Pain exists when the arm is not moving
– Pain with arm numbness
– Pain with arm weakness
– Swelling or a lump near the shoulder
– The intensity changes to sharp pain
– Pain comes back when you are able to perform normal activities
– Visible bone or deformity of the shoulder
You should make an immediate appointment if you have unrelenting pain, changes to severe pain, or that exists at rest. For injuries where a bone or deformity is visible, and for sudden arm weakness and pain, you should seek immediate care from an emergency room or urgent care. These signs may result in permanent damage to your shoulder, and arm numbness and weakness are serious symptoms that could indicate things like a heart attack.
How A Physical Therapist Can Help
Physical therapists are trained in the structure and function of every muscle, bone, ligament, and tendon that make up the shoulder. This qualifies PTs to evaluate the cause of any type of shoulder pain and treat the joint and surrounding muscles, with the goal of preventing the pain from returning. Physical therapists will use manual therapy to mobilize the muscle and joints, exercises to restore correct movement patterns, and educate on appropriate recovery techniques and movements to avoid. Physical therapy stretches for shoulder pain will also help promote flexibility and muscular balance within the shoulder.
No two people with shoulder pain will receive the same physical therapy treatment because the cause and type of pain vary per person. Your PT will design a home exercise program to practice all of the techniques you learn in the clinic at home. They will adjust your plan to match your level of function. One patient may start with simple range of motion exercises for highly irritable conditions and others may begin with high-level strengthening for returning to a sport.
Your physical therapist can be the first provider you see for shoulder pain. If they are not able to help improve your symptoms, they will refer you to another provider. You will be in good hands trusting your physical therapist with nagging injuries. You should always visit an emergency care provider if you need immediate care to prevent more severe problems in your health.
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