It’s not very humerus!
Causes
Most people are going to have shoulder pain at some point in life. Whether you’ve lifted a bit too much weight at the gym, tweaked them playing sport or the weight of the world is weighing on them, shoulder pain can be a pretty nasty time. In this instance, I’m going to explain a common cause of shoulder pain; rotator cuff-related pain.
Shoulder Anatomy
To dig into the shoulder I first want to discuss the anatomy of the shoulder a little bit. The shoulder is a Ball and Socket Joint, which means that it consists of a bone end with a ball and a bone end with a socket. However, unlike the other major ball and socket joint (The Hip), the shoulder joint has a very shallow socket. This is because the shoulder needs to have increased mobility so that we can use our arms for a variety of tasks, unlike the Hip joint with its primary role of facilitating gait.
When you lift up your arm, only about 90 degrees of motion is due to your humerus moving in your shoulder socket. The rest of the motion occurs in tandem with movement of the shoulder blade (or scapula) over the ribcage. The muscles that control this movement of the scapula are grouped together and named “The Rotator Cuff”.
The tendons of the Rotator cuff muscles run underneath the acromion bone of the shoulder and above the head of the humerus in an area called the ‘Sub acromial space’. In general, most of the tissues in this area are implicated in shoulder pain, whether it be a bursa (fluid filled sac), bone, or the tendons themselves. However, even with imaging such as x-rays or MRI, it is difficult to ascertain which structures are causing the pain. Because of this, any shoulder pain without any traumatic mechanism or non-musculoskeletal cause is described as sub-acromial pain or rotator cuff pain syndrome.
Treatment
The treatment for this type of pain is relatively simple; reduce irritating activities and increase strength of the surrounding musculature.
When I talk about reducing irritating activities some patients take this to mean I want them to stop using the shoulder entirely to let it heal, but this isn’t the case at all! It’s important to continue your daily activities as best you can, as long as it only causes mild pain that settles quickly. This helps keep the shoulder moving so that it doesn’t lose any strength or movement, but also stops you provoking your shoulder.
Strengthening will often consist of exercises involving both the major muscles surrounding the shoulder (Trapezius, Deltoid), the rotator cuff muscles, and the muscles that provide stability of the scapula. A good strengthening programme will generally progress in difficulty as your pain reduces, so that the healing tissues are constantly challenged as your pain and function improve.
If you’re experiencing shoulder pain, contact one of our physios for more information and assistance in removing your pain.
