Have you awoken at night in pain while lying on a shoulder? Do you feel sharp grabs of pain in your shoulder or upper arm while reaching up into the cupboard? If you are answering yes to these questions then you likely know how irritating a nagging shoulder injury can be. Shoulder pain can keep us awake at night and limit our day-to-day activities – even the most basic ones like washing our hair or getting dressed. The purpose of this article is to give you a basic understanding of the structure of the shoulder and to discuss some of the common causes of shoulder pain.
The shoulder is a ‘ball and socket’ joint. This means that the top of the upper arm bone has a ‘ball’ like surface, and this ball connects with the concave surface of the shoulder blade, similar to a golf ball sitting on a tee. The shoulder is the most mobile joint in the body, allowing us to move our arm in many different directions and through large ranges of motion.
Although having a lot of mobility in a joint is generally a good thing because of the extra movements that it allows us to do, it also means that the joint undergoes a large amount of strain and therefore can be predisposed to injury. One of the major groups of muscles responsible for protecting the shoulder is the rotator cuff (4 muscles). Another group of muscles that help protect the shoulder are the shoulder blade muscles that run in between our shoulder blades in our upper back. Weakening or tightening of any of these muscles can create injury and pain in the shoulder.
People that spend a large portion of their days sitting often become very weak in their shoulder blade muscles while at the same time also becoming tight in the chest and back of shoulders. This creates an imbalance in the shoulder that often leads to pinching/inflammation of the rotator cuff tendons, often without any specific injury. Other people spend a lot of their workday doing repetitive movements with their arm that also can create irritation and muscle imbalances in the shoulder. At night many of us tend to lay on our ‘favourite’ side while sleeping which squeezes the blood out of the shoulder thus causing further irritation and preventing recovery from the strain during the day.
If pain is felt in the shoulder the best strategy is to avoid the movement that is creating the pain and to ice the shoulder for 20 minutes 2-3 times per day until the pain subsides. Make sure to continue to move the shoulder in all other pain-free ranges of motion in order to prevent your shoulder from getting stiff. Also try as best as you can to not sleep on the painful shoulder at night in order to allow healing.
If the pain does not subside within a week or so it is advisable to see your health care professional so that the specific reason for the shoulder pain can be diagnosed. In physiotherapy, treatment techniques to control the pain and to stretch out tight muscles are typically used initially. Treatment then fairly quickly progresses to focusing on strengthening specific muscle to address the cause of the pain as well as to prevent future recurrence. With a little bit of rest and the proper treatment, your shoulder should be ready for all of your upcoming summer activities!
Graham will be hosting a free information session about shoulder injuries on Thursday, May 26th, 2011 at the Sun City Physiotherapy Clinic in Winfield. Please call the clinic at 250-766-2544 to reserve a spot. Graham Gillies is a registered Physiotherapist at Sun City Physiotherapy Winfield and is a fellow of the Canadian Academy of Manipulative Therapy and a certified Gunn IMS practitioner. He can be contacted at the Winfield location or by email at firstname.lastname@example.org.