Try to say 'sore shoulder surgery' five times fast.
Shoulder pain is a common ailment that can occur in all of us but for many different reasons. Overhead activities such as swimming, throwing a ball, or working with your arms overhead may cause pinching of the rotator cuff, biceps tendon, or many other sensitive structures in the shoulder. Poor sitting postures or hormonal changes may lead to shoulder pain. Trauma such as falls and auto accidents can injure or damage the shoulder. And then there is the times when shoulder pain occurs for absolutely no known reason.
The shoulder is an inherently mobile, unstable joint. It is comprised of a ball (the humerus or upper arm bone) and socket (the scapula or shoulder blade). Purists will like to add the clavicle or collar bone to the structure of the shoulder as well but it is not specifically part of the ball and socket. The ligaments, tendons, cartilage, and muscles that attach to these bones are what gives the shoulder it's stability and allow it to move into infinite positions without falling apart. For the ball to stay positioned in the socket as the shoulder moves into all these positions it takes precise coordination of all these tissues. Any disruption to this precise movement pattern can lead to pain and injury.
Overhead sports such as baseball, swimming, tennis, or volleyball can cause the tendons or bursae in the shoulder to become pinched and irritated, which is simply called tendonitis or bursitis. With these conditions the best approach to recovery is "Relative Rest". This means to rest from the activity that is causing the irritation. But that doesn't necessarily mean to do nothing but rest. The relative part is to correct the reason for why the irritation was occurring in the first place. This is done with strengthening the areas of weakness, typically the rotator cuff muscles; stretching the areas of tightness, typically internal rotation of the shoulder; and correcting any substitution movement patterns. By doing this, when you return to your regular activity your movements should allow everything to position correctly and prevent recurrence of symptoms.
Posture plays a significant role in the stress on the shoulder and it's surrounding tissue. When sitting or standing, if the shoulders are allowed to slump forward there is a constant stress on the tissue and can lead to pain in the shoulder and even the neck. Some theories say posture may lead to adhesive capsulitis, or a frozen shoulder.
A frozen shoulder is an extremely painful and debilitating condition where the shoulder initially becomes very painful and then over time loses mobility due to the tissue around the shoulder joint tightening down. The best analogy of what happens to the tissue around the shoulder in a frozen shoulder is like holding a heat source to Saran wrap. The tissue shrinks up and prevents the shoulder joint from moving. This can last anywhere from 6 weeks to 2 years with little relief. This condition almost exclusively occurs in women between the ages of 40-60 and thus has been thought to be an effect of peri-menopausal symptoms.
Most of the previously mentioned conditions will get better with time, rest, and proper treatment. If there is a structural problem in the shoulder, such as a torn rotator cuff, torn labrum, or fracture, it should be assessed by an orthopedic surgeon. There is usually an incident that leads to a structural problem in the shoulder, such as falling on the shoulder, getting your arm jerked, or an auto accident. Some structural issues do get better with physical therapy treatment, but with a known source of irritation it is unknown to what extent the sore shoulder symptoms will improve.
As a general rule, if the shoulder pain has lasted for more than a few weeks, is not improving, and starting to cause loss of function or mobility then seek out an orthopedist or physical therapist. They will be able to help you get to the source of the problem and get you back to living.
#physicaltherapy #shoulder #rotatorcuff #mthoodpt #labrum #tendonitis #bursitis #frozenshoulder #adhesivecapsulitis #posture
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