Shoulder Pain

Shoulder Pain

frozen shoulder

 

The shoulder joint is made up of three joints: the glenohumeral joint, the acromioclavicular joint and the sternoclavicular joint. The glenohumeral joint, often referred to as the main shoulder joint, is a ball and socket joint formed with the top of the arm bone (humerus) and the glenoid cavity which is part of the shoulder blade (scapula). The glenoid cavity “socket” is made deeper and therefore more stable with a ring of fibrous cartilage called the labrum. The scapula has two bony extensions that extend over the shoulder call the corocoid process, and the acromian, which is where the collar bone (clavicle) meets the shoulder and forms the acromioclavicular joint (AC joint).

The shoulder must be mobile enough for the wide range actions of the arms and hands, but also stable enough to allow for actions such as lifting, pushing and pulling. Muscles that are used for these functions include the deltoid, trapezius, serratus anterior, biceps, and pectoralis muscles.

The strength of the shoulder joint is reinforced with ligaments, muscles and tendons. The Rotator Cuff muscles are a group of four muscles and their tendons which act to stabilize the head of the humerus (ball) in the glenoid fossa (socket) as it moves through range. The tendons form a capsule around the ball and socket. The rotator cuff tendons sit below the bony acromian and are cushioned by a fluid-filled sac called a bursa. This helps prevent the tendons becoming pinched.


Shoulder Impingement

Shoulder Impingement refers to when the structures below the acromian in the “sub-acromial space” (the rotator cuff muscles and tendons, and the fluid-filled sac called a bursa) get pinched when the arm is elevated which may result in swelling, irritation or damage. Impingement will often present as pain in the shoulder region, down the arm or sometimes in the neck or scapula regions. There will often be pain with movement of the arm above shoulder height and also with lifting heavy objects.

Impingement can be seen in any age group. It may be caused by the shoulder blade being in an incorrect position due to poor posture, or perhaps due to weak or tight muscles around the shoulder from weight-training or sport. It can also be caused by repetitive lifting or sustained positions such as above-head work. Impingement can also result from degenerative changes within the rotator cuff tendons, or the acromian can grow bony hooks called spurs which may irritate the tendons.

It is important to diagnose the impingement early so you and your physiotherapist can reduce the pain and restore the range of motion. Treatment will usually involve massage, stretches and sometimes taping to help support the shoulder. Strengthening exercises are important to ensure the scapula and humerus are sitting in the correct position and will be part of your rehabilitation. The good news is that shoulder impingement usually responds really well to conservative treatment and rarely requires surgical intervention


Frozen Shoulder

What is it?

Frozen Shoulder or Adhesive capsulitis refers to when the capsule of the gleno-humeral shoulder joint becomes inflamed and tight. The result is restrictions in range of movement and associated pain. Frozen Shoulder affects 3% of the population, with 70% of cases in women, and usually occurring over the age of 40.

Cause?

The cause is unknown but can occur after trauma, surgery, or untreated shoulder impingement. It has also been related to various conditions such as Diabetes, Parkinson’s disease, viruses and inflammatory disorders.

Phases

There are three distinct phases of Frozen Shoulder which overlap and can take more than 2 years.

  • The first stage is known as the “Freezing” stage. During this stage, shoulder movements become painful and range of movement is limited. Often pain occurs at night and may affect your sleep. It is important to get adequate pain relief from your doctor during this stage.
  • The second stage is known as the “Frozen” stage.  Pain may slowly reduce, but range of movement is still a significant problem. This is the time when physiotherapy and massage can help to restore range of motion and relieve tight muscles.
  • The final stage is known as the “Thawing” stage. During this stage, shoulder range of movement gradually improves and you are able to strengthen and stretch the muscles around the shoulder.  

The Physiotherapists at Your Health Domain Sydney CBD are experienced in assessing and treating frozen shoulders. Our Physiotherapists can provide you with a series of exercises to maintain and improve your movement, stretch your shoulder capsule and to re-train your correct shoulder movement pattern and strength.

Call us on 9251 5111, email  This email address is being protected from spambots. You need JavaScript enabled to view it.   or click here to arrange an appointment with one of our experienced Physiotherapists today


Rotator Cuff Tears

The Rotator Cuff refers to the group of four muscles that surround the shoulder joint stabilizing the head of the humerus in the glenoid fossa “socket”. They also assist in elevating and rotating the arm. A rotator cuff tear can occur in either the muscle or tendon of any (or more) of the group – the Supraspinatus, Infraspinatus, Subscapularis and Teres Minor.

The tear can occur through impingement, trauma or degenerative changes. In fact over 50% of the population over 60 years old will probably have a rotator cuff tear, but the interesting thing is that they may be symptom-free!

The Physiotherapists at Your Health Domain Sydney CBD are experienced in assessing and treating rotator cuff tears. Our Physiotherapists can provide you with a series of exercises to maintain and improve your strength, movement, and to re-train your correct shoulder movement pattern and strength. If further investigations are required we can also refer you onto reputable doctors for on-going management.

Call us on 9251 5111, email  This email address is being protected from spambots. You need JavaScript enabled to view it.   or click here to arrange an appointment with one of our experienced Physiotherapists today

 

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Pitt St. City Practice

Address:
Level 7 60 Pitt Street Sydney 2000
Hours of Operation:
Mon - Fri 7:30am - 6:00pm
Telephone:
(02) 9251-5111

King Street Practice

Address:
Fitness First - The Zone / 94 King Street Sydney 2000
Hours of Operation:
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Telephone:
(02) 9251-5111