Put An End To Shoulder Pain
Shoulder pain can be caused by a variety of factors, and it can be difficult to determine the root cause without professional assistance.
Archer St Physiotherapy Centre is here to help. We are skilled in diagnosing and treating a huge variety of factors that can cause shoulder pain. With the help of our team of experienced physiotherapists, you will be back to your old self in no time!
Discover More About The Shoulder
One of the largest and most complex joints in the body is the shoulder (the glenohumeral joint). The humerus and the scapular meet to form a ball and socket type of synovial joint.
The shoulder has several important bony landmarks including
- Acromion - a bony projection on the tip of the scapula (shoulder blade).
- Acromioclavicular joint - where the clavicle (collarbone) meets the acromion.
- Coracoid process - a projection of the scapula with a hook-like shape.
Other important structures of the shoulder include the:
- Rotator cuff - a collection of tendons from 4 muscles that surround and support the shoulder, providing it with stability while maintaining free movement.
- Bursae - small sacs of fluid that cushion and protect the tendons of the rotator cuff.
- The labrum - a cup shaped piece of cartilage that surrounds the ball-like head of the humerus.
The aforementioned ball and socket shaped joint between the humerus and the shoulder is a relatively loose fit which allows great mobility. A drawback of the high level of mobility is the loss of stability. The shoulder is one of the lesser stable joints in the human body, which means it can be more susceptible to injury..
Causes
Typical Causes Of Shoulder Pain
Many shoulder issues occur when you repeat the same movements over and over again, particularly with overhead actions (like when you paint or swim). There are also other factors that may lead to shoulder pain:
Age.
- Natural wear and tear that comes with age can lead to shoulder issues.
Osteoarthritis.
- The cartilage that protects your shoulder joint can wear down in this inflammatory condition causing pain and stiffness.
Rotator cuff damage.
- Rotator cuff tears or inflammation in the rotator cuff tendons can lead to pain and limitations in range of motion, especially actions behind your back or above your head.
Bursitis.
- Inflammation of the fluid-filled sacs around the shoulder joint, can cause pain, pinching, and difficulty with lifting your arm.
Dislocation.
- The humerus (arm bone) can slip from its position in the socket due to falls or sports injuries, leading to an extremely painful shoulder and injured ligaments and nearby soft tissue.
Frozen shoulder.
- This long lasting condition is characterised by marked chronic inflammation of the shoulder joint capsule, causing the connective tissue to thicken and tighten, greatly restricting all movements.
Common Symptoms Of Shoulder Pain
- Pain - The pain may be localised to the joint, front or back of the shoulder area, upper arm and even up the neck.
- Limited motion - raising the arm, reaching and placing the hand behind the back can be painful.
- Weakness of shoulder muscles - muscle imbalances and weakness can occur when the shoulder is experiencing pain and inflammation.
- Pins and Needles - tingling sensations are often associated with irritated nerves in the neck that can occur in conjunction with shoulder complaints.
- Clicking and Clunking - clicks and clunks can be signs of inflammation that cause disruptions to the smooth movement of the upper limb.
Treatments
Physiotherapy Treatments For Your Shoulder Pain
01.
Ultrasound Treatment
High frequency ultrasound waves can be used to reduce inflammation and improve blood circulation to speed up recovery of soft tissue structures like bursa, tendons and ligaments.
02.
Sports Taping
Useful to support the shoulder joint, limit painful movements, and prevent further injury to shoulder structures. It can also be used to promote appropriate posture.
03.
Dry Needling
An excellent modality to release tight soft tissue structures in the shoulder, upper back, neck and shoulder blade.
04.
Hands-on Manual Therapy
Mobilisation of the upper back and shoulder girdle can help improve movement patterns and release stiffness. Remedial massage or myofascial release can help reduce tightness of muscles to reduce pain and assist improve optimal shoulder mechanics.
05.
Electrical Stimulation
Machines such as Transcutaneous Electrical Nerve Stimulation (TENS) can be used to reduce pain in the shoulder area by blocking pain messages from being sent to the brain.
06.
Heat Therapy
Application of heat can help reduce painful spasms by inducing muscle relaxation and assist recovery by improving blood circulation.
Frequently Asked Questions
FAQ's about Shoulder Pain
Why is my shoulder pain worse at night?
There are a variety of reasons why you might be experiencing shoulder pain in the evenings and why that pain feels worse. Some factors that may contribute to this, include direct pressure on your shoulder when lying on your side, overuse during the day, and gravity pulling on your tendons or ligaments in the shoulder as you lie on your back or opposite side.
There are three common causes of shoulder pain at night: bursitis, tendonitis, or rotator cuff injuries.
Bursitis
Inflammation of the bursa in the shoulder may cause subacromial bursitis. A bursa is a thin, sac-like structure that acts as a cushion between tissues. Repetitive shoulder motions or overhead activity may cause overuse of your rotator cuff muscles which when inflamed can create pressure and friction onto the bursa. Inflammation of the bursa can cause significant pain when lifting or rotating the shoulder.
Lying on your side may compress the bursa in your shoulder, causing pain at night or while trying to sleep that may persist until the injury is properly treated and addressed.
Rotator Cuff Tendonitis or Tear
The rotator cuff is a group of 4 muscles and their tendons that connect the upper arm with the shoulder, these muscles stabilise and assist the shoulder with movements.
Overuse of the rotator cuff tendons may lead to tendonitis (inflammation of the tendon) in the shoulder. With age, tendons become less flexible and more susceptible to injury. A tear to a rotator cuff muscle can be from a traumatic injury or a degenerative onset, this also can cause significant pain, weakness and loss of movement.
There are several factors that can cause more pain at night for those with tendonitis or a cuff tear including reduced blood flow to the area, gravity, and overuse during the day.
What is the rotator cuff?
The rotator cuff refers to four muscles and their tendons, which form the shoulder complex and provide stability and strength during motion. In reference to the first letter of their names (Supraspinatus, Infraspinatus, Teres minor, and Subscapularis, respectively), they are also known as the SITS muscle. From the scapula, these muscles connect to the head of the humerus, forming a cuff around the glenohumeral joint.
There are a variety of upper extremity movements performed by these muscles, including flexion, abduction, internal rotation and external rotation. Most of these muscles play a role in multiple movements, it can even depend on where your shoulder is when starting the movement as to which muscle is doing the most work! Maintaining normal functioning of the entire shoulder girdle requires balance between strength and flexibility in all four muscles.
As a group, the rotator cuff muscles stabilise the shoulder joint, because they regulate the movements of the head of the humerus inside the glenoid fossa. During upper extremity movements, these muscles control the shoulder complex through their neuromuscular control. An example of the rotator cuff performing its role in stability is when walking a dog, if the dog jumps forward suddenly, the rotator cuff will kick in to stabilise the top of your humerus into your shoulder joint.
