Shoulders, Necessary and Complicated!
by Dr. Sue Aery
When it comes to ensuring everyday health and mobility, the shoulder complex shoulders much of the burden. It can also pay a price.
Patients coming in with shoulder injuries are all too common in my office!
Just like other joints, shoulders can be very painful and can cause problems with normal daily life. The shoulder joint acts simply yet is very complex. The four major muscles which make up the rotator cuff are the primary movers and stabilizers of the shoulder complex. This is called the glenohumeral complex, made up of the humerus (upper arm bone) and the glenoid fossa (the joint, part of the shoulder blade).
When the arm moves the hand, it is the explicit job of the shoulder complex. The elbow and wrist are really the secondary (or ancillary) movers of the hand. Now it makes more sense as to why the shoulder is so important in our normal daily activities, especially since we usually need our hands for everyday life!
Most shoulder injuries come on with misuse and repetitive movement, causing an imbalance of the rotator cuff muscles. The function of these four muscles is to be in symphony all the time with a variety of seven different movements. The arm is so complex that it puts a huge demand on this specific and detailed movement of the rotator cuff. Injury, overuse and lack of use can cause just one of these muscles to malfunction and then a cascade of events can lead to a very painful process. In most injuries that involve repetitive use, we usually notice pain as one of the last indicators of a problem that needs to be addressed by a medical professional. This also usually indicates that the problem has been around for a while longer than we might think, creating a longer and more involved healing process.
After being seen in my office, I will often recommend an x-ray to show the bone structure and alignment. This will also show any arthritic changes, loss of joint space or misalignment in the joint complex.
From here, an MRI is the next step when necessary, showing the soft tissues, inflammation and/or a tear in one or several of the muscles involved. Several other possible problems include tendonitis, bursitis, capsular inflammation or a deficiency or tear in the labrum or cartilage.
All of these are more than reason for a pain situation and all need to be addressed as soon as possible. Frozen shoulder is a product of non-use or lack of full range of motion, causing the shoulder to become stuck or frozen in one position, making it very difficult to move at all without pain.
Whatever your pain or inability to move the arm and hand properly, make sure to have the shoulder joint evaluated by a professional. This way, you will know what you need to do next. Several common approaches to shoulder pain/injury include acupuncture, physical therapy, massage therapy, soft tissue therapy, Graston, cold laser, micro-stimulation, chiropractic care and many other hands on techniques.
Establishing the injury first, then putting a plan in place and following through with home care and better habits will ensure that your function will improve and pain will subside. Keeping a full range of motion going on a daily basis is one of the best ways to prevent further injury and allow for full function in the future!