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Posted on 01-12-2015
Types of shoulder injuries/conditions are tears, fracture, strain/sprain, dislocation, tendonitis, bursitis, and impingement. Symptoms of shoulder problems or conditions can be stiffness, tightness, achiness, throbbing, restricted range of motion of the shoulder. The injuries can be located in different areas of the shoulder. The shoulder is a complicated and vulnerable region. There are a number of joints within this region for example the glenohumeral joint, AC joint, coracoclavicular joint, sternoclavicular joint. Many muscles, tendons, ligaments cross the joints to support its vulnerability.
Vulnerability of the shoulder is due to its great mobility. The rotator cuff muscles are asked to stabilize the joint and do not have much assistance from the articular structure. Rotator cuff consists of four muscles that help to stabilize and control the glenohumeral joint. These muscles are the supraspinatus, infraspinatus, teres minor, subscapularis. A rotator cuff injury can involve one to four of these muscles.
Susceptibility to injuries of the rotator cuff are desk jobs with minimal activity of the shoulder then asked to performed a sudden movement – causing a strain. Sudden movements of the shoulder/arm can lead to the vulnerability of the shoulder. Sitting for 6-8 hours a day at a computer will create a significant imbalance. Repetitive use in sports or work conditions such as swimmers, bikers, baseball players, rowers also fall victims to rotator cuff injuries.
Repetitive movements creating micro-trauma over time develop adhesions. These small adhesions over time grow to the point of having significant biomechanical changes in the muscle, other soft tissue, and joint. The changes can be in flexibility, strength, coordination, balance (length-tension). These biomechanical changes increase the strain of the muscle and the body reaches a point it cannot compensate and the pain begins. X-rays/MRIs and other advance imaging to identify tears, inflammation, but has not yet developed the sensitivity to pickup these adhesions.
Long term effects of the shoulder pain can lead to upper/mid/low back pain, neck pain, headaches, TMJ pain, and elbow pain etc. - which would follow the kinetic chain. If the shoulder mechanism is not moving correctly the joint above/below will have to compensate (added stress) for what is lacking from the shoulder and a domino effect occurs.
What can be done at home: posture correction, stretches/strengthening of the shoulder muscles, heat/ice, and rest.
Treatments for shoulder - rotator cuff pain, in our office, consist of manipulation, ART, Graston technique, acupuncture, ice, heat, taping, corrective exercises. These are effective treatments with surprising quick results. Simple stretches and corrective exercises can help the recovery once the adhesions have been released. The corrective exercises help to establish proper balance in the length-tension relationship of the muscles.
Having the shoulder evaluated helps to determine the best treatment option especially if home treatments have not been 100% effective in resolving the shoulder pain.
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