Shoulder Pain
The shoulder joint has the highest range of motion in the body, this is due to the unique ball and socket structure and the various muscles of the shoulder allowing it to achieve this large mobility. Due to the large range of motion it is common for structures the various structures of the shoulder to become strained, torn or impinged.
Rotator Cuff Tear
The rotator cuff muscles consist of 4 muscles. These muscles and tendons are responsible for holding the shoulder joint (ball) within the socket. The muscles or tendons can strain or tear suddenly with large trauma or overtime due to overuse. In some cases surgical intervention is required to repair the torn tendon/ muscle.
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Patients generally experience sharp pain worse at night and limited movement particularly when trying to reach above their shoulders or to the side. There is very strong evidence for Physiotherapy and exercise rehabilitation to treat Minor tears.
Shoulder Impingement
This occurs when a rotator cuff tendon and usually the bursa within the shoulder joint get caught under the bony part of the shoulder called the 'acromoin'. The most aggravating movements generally include reaching above your shoulder and rotating your arm causing the tendon/bursa to become 'pinched' by the acromion leading to inflammation of the tendon and bursa.
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Shoulder impingements can be caused by:
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poor posture
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overuse injuries
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thickened tendons
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trauma to the shoulder
A musculoskeletal physiotherapist will address the cause for the impingement and help to reduce the pain and improve mobility. Evidence shows Shoulder impingements typically respond well to physiotherapy and a specific exercise program.
Referred/ Radicular Pain
The neck and upper back can refer to the shoulder and down the arm. This is called referred pain or if there are neuro symptoms present such as tingling, loss of sensation or muscle weakness then this is Radicular pain. It is important to see a physiotherapist to differentiate the source of the pain.