The shoulder is the most moveable joint in our body. Structured by a group of four muscles and their tendons (a cord that connects muscle to bone) called the rotator cuff, our shoulder joint offers a huge range of motion.
These muscles help to support three bones – your humerus (upper arm), your scapula (shoulder blade), and your clavicle (collarbone) – alongside ensuring support for your glenoid socket.
You may not have heard of a glenoid before, but it’s hugely important! Your humerus fits into a rounded socket in your shoulder blade; this is your glenoid. It’s the icing on the cake, and you’d be rather stuck without it.
As a combination of muscles, tendons, sockets, and bones, you’d be stuck without any one of them. Each individual component brings mobility, but mobility can have its price.
If you injure your shoulder after overexerting yourself, harm your tendons during a fall, or break a bone in an accident, it could lead to increasing problems with the soft tissue and bony structures of your shoulder.
With the mobility of your shoulder impaired, your daily life can grind to a halt. Even getting comfortable in a chair, or trying to get some sleep, can cause chronic discomfort.
Pain in your shoulder can be temporary, but you will need help with diagnosis and treatment. After all, your shoulder is complex, and to heal properly you will require someone with knowledge of how the joint works.
That’s where physical therapy comes in.
Causes Of Shoulder Pain
As one of our largest and most complex joints, our daily life can pivot upon the condition of our shoulder.
From getting dressed, to scratching your back, to driving and throwing the perfect pitch, the joints that allow mobility in the arm need to work in harmony, or else chronic shoulder pain is on the menu.
Most shoulder issues fall into these four categories:
- Arthritis
- Fractured Bone
- Tendon Inflammation or tearing
- Instability
Occasionally, shoulder pain can be a warning sign of a heart attack. But it is likely to be accompanied by restricted breathing and tautness in the chest. You should call 911 for emergency medical attention if you have these symptoms.
What Is Shoulder Instability?
Shoulder instability is where the head of the upper arm bone (humerus) is forced out of the shoulder socket. This issue usually occurs after you’ve suffered a sudden injury, or if you’ve overused the joint playing sports.
Also referred to as a dislocation, this condition can be partial, where the ball of the humerus only partly pops out of the socket. The medical term for this is subluxation. As you would therefore guess, a complete dislocation refers to the ball coming completely out of the socket.
Once you’ve torn the ligaments or caused the ligaments, muscles, and tendons around your shoulder to loosen, then dislocations become more common. Repeated occurrences can cause pain and unsteadiness upon raising your arm or moving it away from your body. This can eventually lead to cases of arthritis.
Arthritis
Arthritis of the shoulder remains very common, and can cause chronic pain in the shoulder joint. While there are various different kinds of arthritis, the typical variant in the shoulder is osteoarthritis; also known as ‘wear and tear’ arthritis.
Causes range from chronic use throughout years of playing a sport, injury at work, and the general effects of aging. This condition develops at a snail’s pace, but the pain worsens to a considerable degree as time marches on.
Symptoms include pain, stiffness, and swelling, and are often related to tears in your rotator cuff, damage to the lining of the joint, or illness (such as an infection).
People who feel the effects of arthritis in the shoulder try to avoid moving their shoulder, as they believe this lessens discomfort. However, this can tighten the soft tissues of the shoulder joint, restricting the range of movement and limiting mobility.
Tendon Issues
There’s a theme with causes of shoulder pain. Injury and age-related degeneration cause changes in the tendons and can bring about splitting and tearing. Whether that tearing is partial or separates the bone from a tendon, it’s going to be painful!
Bursitis is also a common tendon-related issue. Bursae are small sacs of fluid that reside between your shoulder bones, and act as a cushion to reduce friction between interconnected muscles and bones.
These Bursae can become inflamed and swell, creating a condition known as acromion. The overall result creates the conditions for subacromial bursitis to develop.
Then there’s Tendinitis, where the rotator cuff can become damaged and cause inflammation and tenderness just outside a joint.
Bone Fractures
Make no mistakes about it. A fracture is a broken bone, and a shoulder fracture most commonly involves the collarbone (clavicle), upper arm bone (humerus), and the shoulder blade (scapula).
The cause of bone fractures almost always comes from high-energy injuries, motor vehicle collisions, or a fall from a standing height. Broken bones cause severe discomfort and shoulder pain, alongside swelling and bruising.
Can I Treat Shoulder Pain At Home?
We would not recommend trying to self-administer treatment for your shoulder pain at home. You need a professional to unwind the complex mechanicals of your shoulder joint. However, you can certainly apply heat/ice packs to help with swelling.
If you have suffered a fracture, dislocation, or feel concerned about encroaching arthritis, then a physical therapist can help you understand what’s happening to your body. We would recommend seeing your doctor first, as medical assistance is key to resetting your bone and letting it heal correctly.
Your MD may also prescribe painkillers and anti-inflammatory medications (such as corticosteroid injections) to reduce swelling and alleviate pain. In severe cases, rest and medication may not be enough, and surgery may be the best way forward.
If you do end up going for surgery, physical therapy can help with postoperative exercises and care.
However, if you have developed chronic pain in your shoulder without the injury and is not related to a high-energy impact, then physical therapy can help you relieve the pain quickly and effectively. Physical therapists don’t mess about!
How Can Physical Therapy Help My Shoulder Pain?
When you visit an Intecore physical therapist, they will conduct a thorough physical exam to check on your structural shoulder issues, and for anything related to the back or spine that may be causing shoulder pain.
They will then check your flexibility, strength, and range of motion, after talking you through the potential exercises and gauging your response to certain areas of the shoulder. In some cases, they will assist you to perform specific arm movements.
As we have mentioned in previous blogs, we may need additional medical tests to get an accurate diagnosis or confirm our suspicions.
For example, in the case of shoulder pain, these tests can include:
Arthroscopy – a type of surgery involving a tiny fiber-optic camera inserted into the shoulder to get a clear image of what’s causing your shoulder pain.
MRI Scan – this involves using a powerful magnet and radio waves to get detailed images of the inside of your shoulder joint.
CT Scan – multiple X-rays are taken in different positions. When collated, we get a better idea of the shoulder condition affecting your shoulder.
X-rays – helps us identify the cause the specific cause of your shoulder pain – as is the case with arthritis, bone spurs, or other issues causing pain in the shoulder.
EMG (Electromyography) – the muscles and nerves in the shoulder are stimulated to check for electrical activity issues.
How Can I Tell If It’s A Shoulder Injury?
It may sound silly, but it can often be difficult for a person to figure out if their shoulder is in pain, or if it’s their neck. Sometimes, it can be a completely different part of the body causing a domino effect.
Here are some ways to help determine whether you have a shoulder injury:
- Is your shoulder sore and painful?
- Are you unable to move it?
- Can you lift and do other movements even though your shoulder hurts?
- Or is moving it impossible?
- Do you feel pressure on the joint as if it is ready to “pop” out of its socket?
If you feel like these aspects apply to you, and you have a shoulder injury, then it’s essential to get checked over by a physical therapist. Heat therapy can relieve pain and inflammation in the meantime.
If you combine heat therapy with rest, in time, most minor shoulder injuries get better on their own. However, your doctor or physical therapist might recommend a sling for support and ease the pain by limiting movement.
But there are some signs of a more severe shoulder injury that you should not ignore, including:
- Your hand or arm feels numb and/or weak
- You’re unable to lift or move your shoulder at all
- Your shoulder joint looks deformed or “out of place.”
- You have swelling and inflammation, and intense pain
If you have any of the above symptoms, you should seek emergency medical treatment because you may have a shoulder fracture or dislocation.
