The shoulder is the most mobile joint in the human body and can be moved into more than 10,000 different directions. Due to this large amount of movement it also means that it must sacrifice its stability for its mobility and as such has a propensity for injury and shoulder pain.
The shoulder is also unique in that it is a joint that is not supported and protected mainly by its ligaments, but by the muscles that surround it, which is the rotator cuff muscle group. If you have pain in the shoulder it does not mean that it is necessarily from one of these structures. Pain in the shoulder can be from various parts of the anatomy itself, which include the many bursae (fluid filled sacs that allow muscles to glide freely over other muscles, tendons, ligaments and bone), cartilage and joint capsule. Pain can also originate elsewhere as well, it can be referred from the neck, the ribs, shoulder blades and the muscles of the arm. However it can also be referred from various organs in the thorax, including the heart, lungs, liver, gallbladder, pancreas and occasionally the ovaries as well. That is why it is important to seek advice from a healthcare practitioner, only a proper and thorough history and physical examination can differentiate from the various causes and if not found can have serious consequences to your health.
You should seek advice for your shoulder pain when:
- It lasts for more than a couple of days
- There is associated night pain
- Shoulder pain with other systemic signs and symptoms including high fever, redness and swelling of the shoulder region
- Inability to use the associated arm and not being able to move the shoulder including carrying objects e.g. the groceries, having trouble driving, raising your arms up
- A history of chronic pain and previous injury
- Trauma to the area has occurred example a fall on an outstretched hand
- A mixture of clicking, popping, grinding and catching within the joint itself
If you have had any of these on the list below then it is more likely that at some stage you will develop shoulder pain. These include:
- Repetitive overhead activities
- Contact sports involving the shoulder
- History of repetitive injury or traumatic injury
- Occupation especially those with repetitive movements i.e. cashiers, assembly line workers, hairdressers, tradesmen and any other occupation where there is lots of lifting and/or repetitive movement
- Heavy lifting with little rest
- Any of the above coupled with poor job satisfaction
Common Shoulder Complaints
Most shoulder pain that presents to clinic are musculoskeletal in nature and can be treated. The most common conditions of the shoulder in clinical practice are:
- Rotator cuff tendinopathy/tear
- Subacromial impingement syndrome
- Frozen shoulder
- Shoulder instability
- Cervical disc
- Thoracic outlet syndrome
- Labrum tear
These conditions in clinical setting are usually able to be treated without the prospect of surgery although that depends on their cause, chronicity, and also on the damage that is present in the tissue, as well as other biomechanical adaptations and compensations, and whether it is from microtrauma or macrotrauma.
It is best if you do have any pain to get it sorted as soon as possible, the longer it is left alone, the further along the degenerative cascade it will be, making the injury harder to treat, longer to treat, more painful and a greater propensity for reoccurrence and the cycle continues without proper treatment.
There are ways in which you can help yourself prevent a lifetime of pain or even reduce the pain that you have been receiving from your shoulder. Some of these include:
- Keeping a good upright posture with shoulders back and your head balanced nicely on top
- Before any physical exercise make sure that you have warmed up properly by doing a variety of exercises and stretches
- When exercising make sure that you are using proper technique, weights aren’t too heavy and that you are giving yourself enough time to rest, recover and recuperate
- Make sure that the bags that you are using are not too heavy, and where possible rotate the arms on which you rest your bag
- If you do feel pain make sure that you don’t leave it and make sure you get it corrected otherwise it is harder to treat, will take longer and there is less chance for success.
- Keeping regular appointments so that if there are any problems or the beginning of something, there is a good possibility that you are unaware of that until the very last moment when you begin to feel pain, so it is best to take control of something early or before it even begins to cause pain so that we are in control and dictating the terms as opposed to the pain dictating the terms.
What we do for shoulder pain?
If after our consultation we deem that the pain is from a musculoskeletal cause, and not from an organ, and we also deem it is within our scope of practice, a generalised treatment schedule goes accordingly:
- Mainly practitioner provided treatment to help the injured tissues heal including soft tissue work, stretches, mobilisation, joint adjustment and other therapeutic modalities to aid in the correct restructuring of scar tissue.
- Progresses to the above plus various rehab protocols as well including correction of muscle firing patterns, strength and flexibility, joint proprioception work among others. This is the beginning of integrating the shoulder with the whole body. Progression through rehabilitation exercises depends on a number of things including actually committing to the treatment program, age, rate of tissue healing, tolerance, level of joint and muscle injury, pain, and a host of others.
- The last progression is where the whole body is corrected, including poor overall biomechanics, this stage depends on many factors, most of which you control, including positions that you adopt whether that is at work, home or at leisure time. This stage of treatment is crucial, if the poor movement patterns are not corrected properly it sets up the body for more pain in a later stage of life, ultimately leading to more pain.
If there are any questions or queries about your shoulder pain, health or any other information that we can provide, please feel free to make a consultation with us at
Ayr Spinal Care Centre
Alternatively you can call us on 01292 880892 and ask to speak with our chiropractors and they will guide you and help you as best they can.