Overview of shoulder pain
The shoulder joint is likely the most mobile joint in the body. It can move in all different directions, functionally allowing us to use the arm for many different activities. The setback, however, is when we have shoulder pain. Our movement suddenly becomes limited, and our function is severely decreased. Shoulder pain can affect us at any stage of life, from dislocations and rotator cuff tears in our youth to arthritic pain or bursitis as we age. It is important to take care of our shoulders, as limitations can affect our function greatly.
Symptoms of shoulder pain
Shoulder pain symptoms are unique, depending on the type of pain. If you are unlucky enough to dislocate your shoulder or tear your rotator cuff, you are likely to experience quite a sharp shoulder pain. In the event of degenerative injuries, you are more likely to experience a dull shoulder ache.
Different types of shoulder pain include;
Common causes of shoulder pain
It would be nice if we could avoid shoulder pain altogether, but unfortunately, up to 70% of people will experience some form of shoulder pain during their lifetime.
The most likely causes of shoulder pain are;
These problems are mostly associated with a more sedentary lifestyle. Our modern way of working has us sitting for extended periods using computers more and more frequently. It is really important to try and counteract this with frequent breaks throughout the day. We call it movement snacking. Try getting out of your chair every 45 mins to an hour and doing a few stretches. If you’ve made it this far into this article - then perhaps now is a good time!
A more serious injury can develop from activities such as;
Notify your local GP if you have had a serious injury, there is a chance that you may be causing more damage to the shoulder leaving it untreated. If scans reveal no fractures then you may be referred to a physiotherapist for further management.
Top 5 shoulder injuries
As physiotherapists, we see all sorts of shoulder injuries, these are the most common;
Rotator cuff injury
There are some sports which are more susceptible to shoulder injuries;
Cricket / baseball
This one seems pretty obvious, the repetitive throwing of a ball at full pace with an overhead pattern is likely to cause an injury. Generally, cricketers and baseballers suffer overuse injuries. Proper technique and training are essential in minimising the risk.
Swimming requires a lot of overhead movement in combination with power. If you watch a good swimmer you will see that there is also a lot of rotation in the shoulder joint happening with each stroke. Injuries most commonly occur when people overdo it and don’t gradually build up their training program. Take it easy and start slow!
These injuries are more likely to be impactful and potentially worse. Dislocations and fractures are more common than overuse injuries on the rugby field. Good tackling technique and strong musculature are your only defence against injury!
It is the overhead action of the service that is most likely to cause injury in tennis. The force at which players serve is also a big factor. If you’re new to tennis or just getting back into it, then have a lesson and just ease into things. Overuse injuries are common and can have you on the sidelines for quite some time!
Shoulder pain treatment
In the event of mild shoulder pain, there are a few things you can do to try and alleviate it yourself. The focus should be on reducing pain and restoring movement.
With most shoulder pain, overhead movements tend to be the most painful. Start by doing gentle arm swings - this will help increase movement and relax the muscles. It is also helpful to practice overhead activities gently, if you hold a stick/broom with both hands then you can use that to assist you!
Use heat and / or cold
Ice therapy is effective in acute pain and inflammation. If you are injured in a fall or sport then this will be the best approach immediately. If your shoulder pain is more longstanding and/or degenerative then heat can be helpful for pain relief.
Avoid painful movements and exercises
To allow the shoulder to heal and repair, it makes sense not to continue to repeat the movements that cause pain in the first place. Take a break for a couple of weeks - the last thing you want to do is make the injury worse!
The internet is a treasure trove of stretching videos and tutorials. Focus on gentle movements - remember, the stretches should not be painful!
Over the counter pain medication can be used to reduce pain and inflammation. It is best to get the advice of your GP or pharmacist as to what is appropriate.
Seeking medical care
In the event of a fall or sporting injury that results in severe pain, it is best to get the advice of your doctor immediately. Untreated or undiagnosed dislocations and fractures can lead to necrosis (bone death) and vascular injury if not treated properly. These are serious issues with major consequences.
Make an appointment with a physio if
For the most part, shoulder injuries can be managed and treated by your local physiotherapist. It’s not until you injure your shoulder that you realise how many activities become a challenge when you are in pain. From washing your hair to undoing your bra or even chatting on the phone. These usually simple activities become quite a challenge!
Your local physiotherapist will assess your shoulder, focusing on the underlying cause of the injury, movement and limitations that you now have. Using this information, they will devise a treatment plan. The primary focus of treatment is to restore normal range of motion as well as reduce pain. In particular with shoulder injuries, rehabilitation and strengthening is an essential component to recovery.
Treatment for shoulder pain will include;
Frequently asked questions
Why does my shoulder hurt when I lift my arm?
The shoulder joint is complex and has a large range of motion normally. When you elevate your arm, you close down space in the joint and put pressure on all the tissues inside the joint. This is completely normal and happens all the time. When you are injured, inflammation and swelling occur that reduces the available space for movement, making upwards movements difficult and painful.
How do I know if my shoulder pain is serious?
There are some obvious signs of a serious shoulder injury;
How do I get my shoulder pain to stop hurting?
Begin with some of the simple techniques to reduce pain;
If that doesn’t reduce your pain, get the advice of your local physiotherapist.
Anatomy of the shoulder
The shoulder joint is the second ball and socket joint along with the hip joint. The acetabular (socket) is part of the shoulder blade, whilst the humeral head (ball) is part of the humerus.
This ball and socket joint is much shallower than the one in the hip, giving it the ability to move in more directions. The trade-off for this, however, is there is much less stability within the joint itself.
The shoulder joint gets most of its stability from the surrounding ligaments and muscles.
The primary ligaments are;
The muscles around the shoulder joint provide dynamic stability. The rotator cuff muscles are the primary stabilisers of the shoulder;
The bigger muscle groups that sit over the top of the shoulder also add to stability, but their primary role is movement;
The anterior group of;
They are responsible for internal rotation and flexion/elevation.
The posterior group of;
They are responsible for external rotation and extension.