The shoulder provides a versatile range of motion and is comprised of three bones: the humerus, the scapula, and the clavicle. Its joint is the most mobile in the human body and allows circular, forward and backward movement. This wide range of motion is due to the rotator cuff, which is four tendons that connect the muscle to the bone.
What Causes Shoulder Pain?
Several conditions can cause shoulder pain. The most common cause is a rotator cuff injury. A rotator cuff injury can be due to tendinitis, bursitis or tears. Individuals who have to reach overhead repeatedly usually incur a rotator cuff injury like painters and tennis players. Bursitis is caused by an inflammation of its fluid-filled sacs. Rotator cuff tears or strains can occur after a fall or car accident. Any type of shoulder injury will typically cause a lot of pain.
Other causes of shoulder pain include a pinched nerve, frozen shoulder or a dislocated shoulder. A pinched nerve is when another structure is impinging on a nerve. It’s quite painful. A frozen shoulder is where muscles, ligaments, and tendons stiffen and become difficult to move. Activities are generally limited. With a dislocated shoulder, the ball of the humerus comes out of the shoulder socket. And with age, the soft tissues around the shoulder can degenerate and cause pain. Most people will incur some type of shoulder pain in their lifetime.
Diagnosing The Cause of Pain In The Shoulder and Treatment
Your physician will take a medical history and do a physical exam to determine the cause of your shoulder pain. An assessment of joint stability and range of motion will also be performed. An MRI or an X-ray may also be done to help with the diagnosis.
A physical therapist can help evaluate and treat a shoulder injury. The initial evaluation will be a thorough assessment of the nature of your pain. A goniometer may be used to measure shoulder motion, range of motion and strength of the shoulder. Specials tests will also be done to determine which structure is causing the pain. For example, the Yergasons’s test is done to diagnose bicipital tendonitis, and the Empty Can test is a screening tool for injury to the shoulder’s tendons or muscles.
A physical therapist uses different treatments and modalities to treat shoulder conditions. Exercises generally consist of active shoulder motion, passive range of motion, using shoulder pulleys, shoulder scapular stabilization, and rotator cuff strengthening. Other modalities of treatment include ultrasound, heat therapy, electrical stimulation, massage, joint mobilization and cold therapy. These treatment modalities are a perfect adjunct to exercise. Ultrasound and electrical stimulation help decrease pain and improve mobility. With joint mobilization, the joints are moved in specific directions. It’s a gliding motion that is relaxing. The physical therapist also uses massage and kneads the injured tissues of the body to enhance healing. All of these treatment modalities help decrease pain, reduce swelling, improve circulation and decrease muscle tension. Your physical therapists will also instruct you in home exercises to enhance recovery from a shoulder injury. With physical therapy, healing is faster, and you won’t have to rely so much on pain meds.