Shoulder Pain

Rotator Cuff Tendinopathy

 

 

 

 

What is it?      

Rotator Cuff Tendinopathy, "refers to pain and weakness, most commonly experienced with movements of shoulder external rotation and elevation, as a consequence of excessive load on the rotator cuff tissues". The cause of rotator cuff tendinopathy is multifactorial and can be attributed to extrinsic and intrinsic mechanisms, as well as to environmental factors.

 

What does it feel like?

The symptoms or characteristics of rotator cuff tendinopathy are pain and tenderness located in the shoulder-joint with a dull character, especially with overhead reaching, reaching behind the back, lifting, and sleeping on the affected side. 

More relevant in elevation of the shoulder and abduction, unable to reach higher than 90° abduction.

Associated with pain is the growing weakness of your shoulder and inability to move.

 

Why does this happen?

  • Awkward Postures​

  • Heavy Work

  • Direct Load Bearing

  • Repetitive Arm Movements

  • Working with hands above shoulder height

  • Lack of Rest

  • Muscle Imbalance

  • Decreased Flexibility

  • Overweight

  • Advancing Age

  • Certain Sports (Repetitive Arm Motion)

Biceps Tendinopathy

 

 

 

 

 

 

What is it?      

Proximal biceps tendinopathy is the inflammation of the tendon around the long head of the biceps muscle. Acute biceps tendinopathy may occur because of sudden overuse, especially among athletic patients aged over 35 and any patient aged over 65. 

 

What does it feel like?

Patients will typically report an insidious onset of discomfort around the region of the involved tendon.

Patients with biceps tendinopathy often complain of a deep, throbbing pain in the anterior shoulder that is intensified when lifting.

The pain is usually localised to the bicipital groove and might radiate toward the insertion of the deltoid muscle.

Why does this happen?

Bicipital tendinopathy may be related to shoulder laxity and instability. Tendinopathy at the proximal end of the biceps may be related to traction overload tendinopathy. The biceps long head acts as a humeral stabilizer as well as a decelerator of elbow extension. When there is increased translation of the humeral head with activities, more stress is placed on the biceps and ligamentous structures. Activities that include repeated shoulder abduction with external rotation such as throwing may result in impingement of the biceps tendon in the bicipital groove beneath. 

Labrum Tear

 

 

 

 

 

 

 

 

 

 

 

What is it?      

Unless it causes you pain, you might never give your shoulder’s labrum a thought. This thick band of tissue surrounds your shoulder socket and keeps your shoulder joint stable. It’s soft tissue that helps connect the socket part of the scapula (called the glenoid) with the head of the humerus. If the labrum tears, there’s not enough cushion between those bones.

What does it feel like?

  • In most cases, a labrum SLAP tear doesn't hurt all the time. The pain usually happens when you use your shoulder to do a task, especially an overhead activity. 

  • Catching, locking, or grinding feeling

  • An unstable feeling in the shoulder

  • Loss of strength

  • Low range of motion

Why does this happen?

Overuse- Anyone who uses their shoulder to make the same motion over and over can tear their labrum. You might repeat an overhead motion at work or during activity. Think of a weightlifter who jerks a barbell up again and again.

Injury - When you slip, it's normal to stretch out your arm to break the fall. The impact on the extended arm can cause a labrum tear. You can also tear your labrum in a car wreck, by dislocating your shoulder, or while doing something that pulls hard on your arm.

Wear and tear-  Day in and day out, your labrum does a lot of work. If you're 40 or older, it’s a common issue.

Frozen Shoulder

 

 

 

 

 

 

 

 

 

 

 

What is it?      

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.

Your risk of developing frozen shoulder increases if you're recovering from a medical condition or procedure that prevents you from moving your arm.

What does it feel like?

Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months.

  • Freezing stage - Any movement of your shoulder causes pain, and your shoulder's range of motion starts to become limited.

  • Frozen stage - Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes more difficult.

  • Thawing stage - The range of motion in your shoulder begins to improve.

  • For some people, the pain worsens at night, sometimes disrupting sleep

Why does this happen?

Whiplash injury usually results from sudden flexion and extension of the neck due to rear-end or side-impact car accidents.

Thoracic Outlet Syndrome

 

 

 

 

 

 

 

What is it?      

Thoracic outlet syndrome is a group of disorders that occur when the blood vessels and/or nerves that run from your neck down your arm become compressed. The three main entrapment sights are at the scalene muscles, between the clavicle and 1st rib and at the Pectoralis minor muscle.  

 

What does it feel like?

  • Numbness or tingling in your arm or fingers

  • Pain or aches in your neck, shoulder or hand

  • Weakening grip

  • Discoloration of your hand (bluish color)

  • Lack of color (pallor) in one or more of your fingers or your entire hand

  • Weak or no pulse in the affected arm

  • Cold fingers, hands or arms

  • Arm fatigue with activity

  • Numbness or tingling in your fingers

  • Weakness of arm or neck

 

Why does this happen?

  • Anatomical defects - Inherited defects that are present at birth (congenital) may include an extra rib located above the first rib (cervical rib) or an abnormally tight fibrous band connecting your spine to your rib.

  • Inefficient posture - Drooping your shoulders or holding your head in a forward position can cause compression in the thoracic outlet area.

  • Trauma -  A traumatic event, such as a car accident, can cause internal changes that then compress the nerves in the thoracic outlet. The onset of symptoms related to a traumatic accident often is delayed.

  • Repetitive activity - Doing the same thing repeatedly can, over time, wear on your body's tissue. You may notice symptoms of thoracic outlet syndrome if your job requires you to repeat a movement continuously, such as typing on a computer, working on an assembly line or lifting things above your head, as you would if you were stocking shelves. Athletes, such as baseball pitchers and swimmers, also can develop thoracic outlet syndrome from years of repetitive movements.

  • Pregnancy. Because joints loosen during pregnancy, signs of thoracic outlet syndrome may first appear while you're pregnant.

Bursitis/ Subacromial bursitis

 

 

 

 

 

 

What is it?      

Shoulder bursitis is an inflamed shoulder bursa. Your bursa is a fluid-filled sac that helps to reduce friction in your shoulder spaces. You have several bursae within your shoulder. Your subacromial bursa is the most commonly inflamed of the shoulder bursa.

Subacromial bursitis is a common cause of shoulder pain that is usually related to shoulder impingement of your bursa between your rotator cuff tendons and bone (acromion).

 

What does it feel like?

  • Gradual onset of your shoulder symptoms over weeks or months.

  • Pain on the outside of your shoulder.

  • Pain may spread down your arm towards the elbow or wrist.

  • Pain made worse when lying on your affected shoulder.

  • Pain made worse when using your arm above your head.

  • Painful arc of movement – shoulder pain felt between 60 - 90° of the arm moving up and outwards.

  • When your arm is by your side there is minimal pain and above 90° relief of pain.

  • Shoulder pain with activities such as washing hair, reaching up to a high shelf in the cupboard.

 

Why does this happen?

Injury or strain to the shoulder joint causes shoulder bursitis. Activities that are common risk factors for shoulder bursitis include throwing a ball, lifting objects overhead, and trauma from a fall onto the shoulder.

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