Shoulder Impingement: Shoulder impingement is more a symptom than a primary injury. It occurs in individuals of all ages but it is more commonly occuring after a shoulder injury or in individuals who are involved in throwing or exercising. The shoulder blade, the collar bone and the arm need to work in a synchronized manner for smooth shoulder movements. When this phenomenon does not occur, it results in shoulder impingement which may feel like a sharp pinching pain.
Bursitis: Bursa is a soft structure which acts as a cushion within the joints to avoid excessive friction in the joint during movements. However there are times when these bursa undergo injury, tend to get inflammed and cause pain.
Rotator Cuff Injury: The rotator cuff is a group of muscles that provides dynamic stability to the shoulder as it is attached deep in the shoulder. An injury to this group of muscles requires supervised training in order for the patients to identify movements to specifically target this muscle group.
Shoulder Dislocation: A dislocation occurs due to a significant force or trauma to the shoulder. In this instance the head of the humerus is pushed out of the socket. Supervised physiotherapy and a structured long term rehabilitation program is recommended in order to regain shoulder movements and control. More importantly, prevention of recurrent dislocations needs to be addressed in the rehabilitation program.
Frozen Shoulder: This condition is more commonly seen in women and even more prevalent in people with diabetes. The exact cause of frozen shoulders is still not fully understood, however, it follow a self resolving course and symptoms reduce within 2 - 3 years. Physiotherapy and rehabilitation is recommended in this condition in order to mantain shoulder function and strength. It is very common for people to reduce the use of their painful shoulder which limits functioning in the long term.
Pain: As in any injury, pain is a common symptom of majority of the shoulder injuries. However, it may be of variable intensity in different conditions. An impingement syndrome will typically present with a sharp pinch like pain in particular shoulder movements, particularly with over head lifting or lifting your arm to the the side. Additionally, you may feel that it is painful to sleep on the affected side and rolling over it in bed may cause pain and discomfort at times.
Loss of Range of Motion and Strength: Majority of the injuries are painful and as a result we tend not to use a painful joint or limb. Unfortunately, as a result we tend to loose range of motion and strength in the shoulder joint which leads to reduce functional capacity.
Instability: An unstable shoulder may significantly reduce your day to day functioning. It usually occurs as a result of injury and subsequent poor rehabilitation. People with unstable shoulders may feel apprehensive to do certain movements as they may also be associated with pain. Unstable joints may also dislocate or subluxate from time to time which may require medical attention and pain management.
What can be done….
Pain Management: Initial management for an injury can include Protection Rest Ice Compression Elevation (P.R.I.C.E) until you can see your health care professional. Physiotherapy management will be tailored to your specific condition and symptoms following a detailed assessment. Some of the interventions for pain management may include Joint mobilization, Dry Needling and TENS. Your GP may also recommend Paracetamol (Panadol) as first line of pain management medication.
Strength Training: Regaining full range of shoulder movements and improving the strength and endurance is a vital component of recovery. Strengthening ensures that you regain optimal strength in order to carry our your daily activities without pain and discomfort. It also assists in preventing any further injury or future injuries of the shoulders. Shoulder rehabilitation normal encorporates Rotator Cuff strengthening and Scapular stabilization exercises, which we will explain in further detail during your appointment.
Biomechanical Correction: Strengthening, endurance, muscle activation, corrective taping are all part of aiding correct mechanics of your shoulder in order to prevent future injury and relieve symptoms associated with incorrect posture or joint mechanincs. Very often, biomechanical correction can relieve the symptoms immidiately.