The shoulder is built for mobility not stability. So it relies on the capsule and rotator cuff muscles to stabilise it.
The rotator cuff is made of four muscles. The come from the shoulder blade (Scapula) and connect to the arm (Humerus). They rotate the shoulder joint (glenohumeral joint) so we can orientate our hand.
Athletes through over use can be prone to rotator cuff tears include:
- Tennis Players
- Throwing Activities, like bowlers in Cricket.
The imbalanced use of the shoulder can lead to an imbalance in the rotator cuff muscles. Some muscles become too tight and others too weak. Then the tendons can become inflamed.
You can get a rotator cuff tear by
- Falling on your shoulder.
- Using an arm to break your fall.
- Lifting heavy weights.
Shoulder Impingement. Rotator Cuff Tear (Often the Supraspinatus) or Sub Acromial Bursitis.
An imbalance in the rotator cuff often leads to the supraspinatus tendon becoming excessively loaded. The supraspinatus helps hold the joint together as it is under tension while you are standing. So it works hard. Any extra work, through over use or working against the other rotator cuff muscles can use inflammation in the supraspinatus or sub acromial bursa. This can be seen in a painful arc. Pain on moving your arm sideways away form your body. It is normally felt between 60-120 degrees.
Due to the fact the shoulder is so mobile it makes it less stable. Therefore any injury or overuse can damage the structures that stabilise the joint. This can lead to subluxation (Partial dislocation / slipping of the joint) or dislocations. (The head of the bone is forced out of the socket). The more times the joint dislocates the more likely it is to do so in the future.
Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder is a condition that occurs due to inflammation and thickening of the capsule around the shoulder joint. It may occur after injury to the shoulder or arm. The joint isn’t moving properly so inflammation builds up around the joint and capsule. The sufferer starts to use the joint less and so the capsule can begin to thicken. This can occur over many months very slowly. It can a long time to resolve.
Osteopathically all the above can be treated to some level depending on the amount and severity of the damage. We can work on the muscles, joints and give exercises to improve the mechanics. It is also important to understand that using the shoulder does not cause pain in the shoulder only. So issues in the hand, wrist, elbow and neck all can lead to the problems occurring within the shoulder. It can also mean that the problem does not resolve. Please contact us if you require any advice regarding shoulder problems.