The painful shoulder without trauma
Your shoulder is made up of three bones : the humerus , shoulder blade ( scapular) and collarbone ( clavicle) . These have 4 joints the genohumeral joint, Scapulo thoracic joints , acromioclavicular and sternoclavicular joints. Pain from the shoulder complex is felt either over the deltoid area , front of shoulder, around the shoulder blade or less commonly over the spine. The pain may be due to misuse of the muscles controlling the whole shoulder complex , causing fatigue, increased muscle tension and poor posture. IT may result in irritation in the bursa or tendons.
Pain can also be referred from the spine and not related to shoulder movements at all. Or you can have a combination of the 2.
Your physio can assess your spine and shoulder through various movements related to your symptoms and determine what needs to be treated to resolve your pain. Everyone is different!
With pain arising from a problem with the shoulder complex ,exercises to shorten the lever length, improve initiation of rotator cuff muscles ( should come on a few miliseconds before the shoulder moves)and facilitate correct scapular control are used to.
Improve mechanics and so ease pain. Adding lower limb activation may also help to enhance shoulder control.
Here I am demonstrating an exercise that utilises all these things.(attached ) Weight bearing exercise through the upper limb such as plank or all fours are great positions to stimulate co contraction of stabilising muscles around shoulder complex.
If the shoulder is stiff massage and mobilising will be used and exercises to stretch the capsule or muscles such as shown.
Frozen shoulder is a painful condition of unknown cause that progresses through various stages in its course. Initially pain is the predominant symptom and a cortisone injection into the joint or good pain relieving meds is important. As the pain reduces stiffness becomes the major issue and this is when physio is most important to help you regain full range . Weight resisted exercises then target the weak range.
If pain is referred from the spine perhaps due to poor posture or straining the muscles and joints of spine during exercises or a header in soccer massage , mobilisations, postural taping and specific stretches and postural correction works amazingly well.
