SHOULDER INJURIES

SHOULDER INJURIES   The shoulder is the most mobile and flexible joint in the human body and it allows us to perform one of the bodies most important functions: controlling the movement of our arms.   The shoulder comprises the shoulder blade (scapula) which hangs off the collar bone (clavicle) at the front and a delicate array of muscles, tendons, ligaments, and nerves which hold these in place and allow fluid movement. These all work together in a delicate balancing act, and injuries to the shoulder can upset the balance, causing you to have a significant amount of pain and shoulder problems.   The most common cause of shoulder pain is poor shoulder posture. Poor posture can lead to muscle imbalances around the shoulder girdle region which places increased stress on the shoulder joint structures and leads to tissue breakdown and injury. This is particularly prevalent in sports which utilise the upper limbs such as tennis, swimming and surfing.   Types of ‘Shoulder’ injuries commonly presenting to a physiotherapist are rotator cuff tendonitis and tears, frozen shoulders (adhesive capsulitis), AC joint strains, and long head of biceps tendonitis. It is fair to say that a majority of traumatic shoulder injuries are predisposed to by poor posture. However one of the most common causes of shoulder pain is the neck. The levels between C4-6 regularly refer to this area.   More specifically shoulder pain can affect a number of areas of the shoulder. The upper arm can relate to shoulder joint (ie frozen shoulder) or rotator cuff tendon problems. If this pain is in the front of the upper arm, this usually relates to a long head of biceps injury. Pain on the point of the shoulder is usually due to AC joint injury, a common one with footballers. Pain between the neck and the shoulder, usually relates to neck and first rib problems.   Treatment Management of shoulder injury is optimised by: postural correction; improving muscle balance between the chest muscles and the muscles at the back of the scapula; massage and mobilisation of the shoulder joint; or drugs to reduce inflammation. These may include a cortisone injection or non-steroidal anti-inflammatory drugs. Occasionally damage to the shoulder is too severe to be helped by conservative measures such as physiotherapy. In cases such as these I would recommend the patient seek an orthopaedic opinion and surgery may be required.