The shoulder is one of the most fascinating regions of the body. It is comprised of four joints, with many muscles and ligaments which hold it together to make it one of the most mobile joints in the human body. In order to use the arms for any activity, the 4 joints have to act synchronously in order to effectively promote movement.
We often take the behavior of the shoulder complex for granted, given its ability to provide power to the upper extremity, enabling us to accomplish the most basic activities of daily living, such as eating,
dressing, and reaching.
What happens when something goes wrong in the shoulder? Because of its immense mobility, the shoulder is inherently highly unstable. If one or more of the four joints are dysfunctional, problems can develop that can lead to painful, aching shoulders. For example, what if you fall and dislocate your shoulder? Or if you develop a rotator cuff problem? A whole lot of compensation has to occur in order for you to be able to complete your daily activities, which can lead to pain and cause problems in surrounding regions, such as the neck and elbow. As a physical therapist who loves to treat shoulder disorders, I can vouch for the fact that these issues can make patients really miserable.
The good news is that there are things that you can do to avoid injuries, such as rotator cuff tendon problems, impingement, and arthritis. The chief role of the four rotator cuff muscles is to keep the head of the humerus, or the “ball”, centered in the glenoid fossa, or the “socket”. There is a roof over this glenohumeral joint called the acromion, which is part of the shoulder blade. If that ball does not stay centered on the socket with arm motions, it can migrate upward and cause compression to the tissues just below the acromion. This can happen if the rotator cuff is not strong enough, or does not have enough muscle endurance to properly keep the joint in alignment. This is called impingement syndrome. Typical symptoms include pain with overhead reaching or lifting, sleeping, or reaching across the body. A physical therapist will evaluate how well the shoulder blade and upper arm bone move together as a unit and can help restore normal movement patterns with manual techniques to free these regions up so that they move properly. A PT can also prescribe a specific strength and endurance training routine that is simple to replicate and is highly effective in restoring normal joint mechanics. As the shoulder complex learns how to synchronously operate as a unit, the pain subsides and function is restored.
If impingement syndrome continues for a long time, not only will pain and disability worsens, but it can also cause debilitating arthritis at the glenohumeral joint from the humeral head rubbing against the acromion due to the superior migration of the bone. The rotator cuff muscles will continue to weaken and can even tear as a result. Arthritis in the shoulder joint can be quite painful and severely disrupts normal everyday life.
If you are experiencing shoulder aches and pains, why not have a physical therapist examine it? We can make a tremendous difference in the mechanics and function of this fascinating joint to prevent serious issues in the future. In fact, research has shown that conservative rehabilitation in the management of rotator cuff alone produces results equal to those produced by arthroscopic surgery and open surgical repair.¹ Rotator cuff issues are a common problem. Studies have shown that 30% of those under the age of 70, and 70% of those over age 80, have a rotator cuff tear. And these are people with no symptoms of shoulder pain.2 So let a physical therapist intervene today to prevent your aching shoulders from taking over your life!
1. Kukkonen,J.etal.Treatmentofnon-traumatic rotatorcuff tears:A randomisedcontrolled trialwithone-yearclinical results.
2. Iannotti,JP “Full-ThicknessRotatorCuffTears”JAm.Acad.Ortho.Surg.,Mar1994;2:87 -95.
Click to view our May 2019 Newsletter to learn more about relief from shoulder pain at Excel Physical Therapy!