Shoulder pain

Shoulders are tricky. They're the most mobile joints in our body letting us move through a full 360 degree circle as we throw a ball. But all of that mobility leaves our shoulders at risk for injury. What other joint gets dislocated more than a shoulder? Unlike your hip which forms a stable ball and socket style joint your shoulder joint is more like a golf ball balancing on the face of a sand wedge. It takes a great deal of muscle coordination to keep that joint in a comfortable place. 

Causes of shoulder pain

Rotator cuff injury results when the shoulder joint is allowed to move too far from its normal position. This often results from a weakness or previous injury to those rotator cuff muscles. Those with rotator cuff injuries will typically need to reach around to the back of their shoulder and try dig their fingers into painful muscles to find some sort of relief. This is because that excessive shoulder motion has caused an over-stretching or tearing of rotator cuff muscles. If left unchecked these injuries lead to a downward spiral of shoulder stability as these now injured muscles are less capable of controlling shoulder motion and further injury can occur.

Shoulder instability is often seen in someone with a prior shoulder injury or dislocation. These individuals often have difficulty in certainly position like reach overhead, or pushing their arm back as they put on a jacket or sweater. In some cases these indivuals will frequently dislocate their shoulders with little force. Beyond injury to the rotator cuff those with shoulder instability may have injured the ligaments, capsule or labrum of the shoulder joint.

Shoulder impingement gives a sharp stab or pinch on the very top of your shoulder often felt the strongest when reaching overhead. In more severe cases it can result in pain felt down the arm. This is most often felt when a tendon of the rotator cuff is pinched between two bones at the top of your shoulder. As with any shoulder injury the longer its left unchecked the higher the likelihood of further injury.

Frozen shoulder is commonly confused with shoulder impingement since they both make it difficult to reach overhead. Unlike impingement, frozen shoulder results from the structures around the shoulder becoming tight rather than loose. This condition is more prevalent in individuals over 50 years of age and if left unchecked can result in the progressive loss of shoulder movement and function. 

Care for shoulder pain

The majority of shoulder injuries stem from some level of instability. This type of injury requires protection from stressful movements, especially those that create a feeling of instability. Affected muscles and structures supporting the shoulder joint need specific treatment and a rehabilitative program to strengthen and better coordinate the shoulder. These exercise progress from building stability in resting position, in more functional (real life) movements and finally improving stability in position or movements that would normally cause feelings of instability.

Like frozen shoulder not all injuries result from instability and that's part of the reason that the best care for a shoulder injury is having a qualified care provider like your family doctor or chiropractor perform a proper shoulder exam to correctly diagnose your specific injury.

The shoulder blade

Another unique feature of the shoulder is that it attaches to another unstable structure, the shoulder blade. Your shoulder blade is almost completely held in place by muscle as it glides over your rib cage to help your shoulder move through such a broad range. The important point here is that no matter how strong your rotator cuff becomes if its pulling on an unstable shoulder blade it can't provide any support. Imagine a child on a monkey bar, sure the bar is welded strong to the frame but if the frame isn't bolted down one big swing could bring the child crashing down. The same concept applies to the shoulder blade. If its stable and well coordinated if give the rotator cuff a solid base from which to stabilize the shoulder. 

Again. Shoulders are tricky.

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Shoulder injuries can be serious. Dislocations can result in long lasting disability and even neurological damage, always consider a dislocation a serious situation. The provided information is in no way a guide to treating shoulder injuries.

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