The shoulder is one of the most unstable joints in the body. It is mostly held together by muscles. The shoulder is designed to allow plenty of motion so that you can reach up, down, back, forward or outward. Although it is great to have all of this movement, it creates a lot of instability. This makes our shoulders prone to dislocations, muscles strains, micro-tears and nerve impingement.
Causes of Shoulder Pain
Nerve impingement happens when the alignment in the shoulder is wrong. You'll notice pain when you raise your arm up to reach out in front of you and above your head.
Dislocated shoulders mean that the ball of the shoulder has fallen out of the socket. This usually happens because of muscle weakness, or because of excessive forces during movement. The pain happens suddenly and is quite severe. You won't be able to move your shoulder very much.
Rotator Cuff Tears are very common and can vary in severity from minimal tears to complete tears. This usually happens due to repetitive strain. With this type of injury, you'll feel pain when you are moving your arm in specific directions.
Arthritis is another common cause of shoulder pain and will give you a sense of ache within the joint itself. This pain usually gets worse when you are not moving (like at night) and gets better with movement. People at risk of arthritis are those that have very physical and active lifestyles, like lifting heavy items or performing a high impact sport.
Symptoms of Shoulder Pain
Pain to the front of the shoulder
Pain into your neck
Pain in your upper back
Pain shooting down your arm
Tingling or numbness shooting down your arm
Weakness in your arm
Diagnosis of Shoulder Pain
Imaging is one way to see what is happening inside your shoulder. Having an X-Ray, MRI or ultrasound of your shoulder can give your family physician a good idea of what you are dealing with. Although helpful, imaging is not always necessary.
Physiotherapists are regulated health professionals who are specifically trained to test and diagnose all sorts of injuries using special tests and techniques.
A physiotherapist has the ability to place stress on every structure around the shoulder to see which one is irritated. With a muscle test, they can identify if a muscle is weak or injured. With their hands, they can find bony landmarks around the shoulder to see if the bones are lining up properly. With nerve tests, they can verify if any nerves are being irritated. They can even check your circulation.
Most physiotherapists communicate with your family physician to keep them up-to-date on the findings. This gives your physician more information on how to proceed and better help you reduce your pain.
Treatment of Shoulder Pain
Depending on the cause of the pain, treatment will vary. In most cases, applying ice to the painful area will help temporarily relieve the pain.
Manual therapy is usually beneficial to increase blood flow and encourage the joint to move the way that it is designed to. Your therapist might perform some passive range of motion, which means moving your shoulder for you while you stay completely relaxed.
As your shoulder heals, you will begin strengthening exercises specific to your needs. At this point, your physiotherapist should be looking at the rest of your posture to make sure that everything is working properly. If you've had an injury to your shoulder, it is important to fix the root of the problem (why did you get injured in the first place?).
The last step is to return to functional activities. The most important thing is to learn how to complete your daily activities without triggering your shoulder pain. This is how you make sure that it never comes back!