Is shoulder pain giving you the winter blues? ????

Do you have a frustrating ache in your shoulder when you’re trying to sleep? A sharp pain
when reaching up into the cupboard? Or issues holding the steering wheel on a long drive? If
so, this could be a one of many signs you could be suffering from a niggling shoulder injury.
If you want to learn more about the shoulder, look no further than 13th Beach Health Services.
This article is going to give you the information into why you could be experiencing this pain
and the tools we can use together to eliminate these niggles from your life.

Alright so let’s delve into the shoulder complex, its anatomically made up of three bones, the
humerus, the scapula and the clavicle. These three bones along with the thoracic rib cage
make up the four joints of the complex.

The Glenohumeral Joint (GH)

The GH joint is a ball and socket joint formed by the humerus and glenoid cavity of the
scapula.  The shallowness of the glenoid cavity combined with the congruency of the two
bones allows a high degree of mobility allowing us to freely move our arm in a 360* arc.
Unfortunately, this amazing range of motion gives rise to its inherent instability and
subsequent injury, in fact it is the most commonly dislocated joint in the body.

The Acromioclavicular Joint (AC)

The AC joint is saddle type joint and is formed by the lateral aspect of the clavicular and the
acromion process of the scapula. This joint acts as an anchor to link the motion of the
scapula, to the motion of the upper extremity which allows smooth movements at the end of
your range. The AC joint is often injured through significant impact injuries seen in contact
sports such as AFL.

The Sternoclavicular Joint (SC)

The SC joint is made up of the medial aspect of the clavicular and manubrium of the sternum,

it primary function is to help stabilise the upper extremity as it is the attachment to the axial
skeleton. It is quite rare to see an injury to this joint, as a fracture in the clavicle usually will
supersede this from occurring.

The Scapulothoracic Joint

The scapulothoracic joint is technically not a true ‘joint’, however it plays a pivotal role in

shoulder complex movement. It provides accessory movement of the scapula on the posterior
rib cage that aids in the movement of the upper extremity. This ‘joint’ isn’t usually the
primary cause of injury or pain however the biomechanics of the scapulothoracic joint need
to be assessed and maintained to help the rehabilitation of many shoulder injuries.

Predominately when we are considering shoulder complex injuries the term ‘rotator cuff’ is
thrown around. The rotator cuff consists of four muscles running from the scapular to
humerus. The muscles include Supraspinatus, Infraspinatus, Teres Minor and Subscapularis
and along with the Deltoid, Biceps, Triceps, Pectorals and a few others they all work together
as the prime movers in shoulder range of motion

With so many muscles, tendons, ligaments, nerves and bursae in such a confined space it’s no
wonder that that we can easily irritate one or more of these structures. With irritation come
nociceptive activity and if you have read our blog on pain, you’ll know that with nociceptive
activity comes pain. The types of injuries that can cause this manifestation of pain are vast,
but we are going to explore a few of the common injuries that we see in this region.

Shoulder Impingement: This injury occurs when tendons or bursae become impinged
between the top of your humerus and your acromion process of your scapula in a space we
call the sub – acromial space. Commonly seen in many shoulder injuries an impingement can
cause severe pain and can also develop into further injury. Pain with overhead activities,
lying on your shoulder and muscle weakness lifting are some of the signs you want to look
out for before. As the severity of the shoulder impingement develops rotator cuff
tendinopathy, Bursitis & Muscle Tears become more likely to occur.

Rotator Cuff Tendinopathy is an injury that involves the rotator cuff tendons that’s are
associated with the four muscles mentioned earlier. These structures becoming swollen,
inflamed and weak. Patients with this condition often have an associated Bursitis which is an
inflammation of synovial fluid filled sacs, which acts as a cushion between tendons and other
joint structures. With these two conditions patients usually complain of pain at the front and
side of the shoulder with associated muscle weakness in certain shoulder movements
dependent on the muscles involved. Excessive overhead or rotational activities are the most
commonly seen movements that provoke this pain.

The last of the conditions we are going to look at today are muscles strains/tears. Strains
and tears can occur in any muscle from an acute incident or from an overload of the muscle.
In the shoulder complex we see both causes provoking injury, we often associate the rotator
cuff with the repetitive nature of injury and other prime movers with an acute incident, but
this can vary. If you have strained or torn a muscle that acts on the shoulder you may find,
pain on certain movements, pain on resistant activity, bruising and swelling. If you feel this is
the case it is wise to apply the PRICE protocol of Protect, Rest, Ice, Compression &
Elevation in the first 48 – 72 hours before seeking further assistance.

The treatment of shoulder injuries is dependent on the type of injury, different types of
injuries required specific treatment and rehabilitation, that is where our highly skilled and
experienced practitioners can be of assistance, we will endeavour to:

 Provide symptomatic relief through manual therapy techniques.
 Provide important information on what is happening in your shoulder, and why that is
provoking pain.
 Provide you with activity modification techniques to avoid aggravating positions and
 Improve the range of motion of upper limb and scapula.
 Correct any muscle imbalances or biomechanical deficiencies.
 Prescribe exercises to improve your strength and consolidate correct biomechanics.

Most importantly our treatments will focus on your individual needs and encourage the body
to heal and train itself into the best possible movement patterns for the joint. If you do suffer
from shoulder pain be sure to get in contact with us here at 13th Beach Health Services as
there are many possible injuries that the shoulder can be susceptible too. With our clinic
offering a wide range of modalities we can identify which practitioner you will be best suited,
ensuring you see the results you deserve.

shoulder pain

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