Shoulder Pain is common:

Every year 1.5% of us see a health professional for help with shoulder pain. This equates to about a 70% likelihood that any one of us have or will suffer from shoulder pain in our lifetime.

Your shoulder pain could be:

-> Shoulder capsule: – tear, irritation, instability, adhesion, internal impingement
-> Rotator cuff muscles + tendons: overuse, tear, external impingement
-> Shoulder bones: Osteo-arthritis or fracture
– Rotator cuff or tendon overuse
A group of deep muscles, that help to stabilise the shoulder during all activities. The 4 muscles are:
– Subscapularis
– Infraspinatus
– Teres minor
– Supraspinatus
Micro-trauma and inflammation accumulate, if we overuse and under-rest shoulder muscles and tendons. Of note is the fact that is degenerative shoulder tendons + weak rotator cuffs are more susceptible to becoming overused.

– Rotator cuff tear

As opposed to an overuse injury, a tear happens through a direct trauma, usually when the muscle is yanked. There are 3 different grades of muscle tearing, with each one being more severe:
Grade 1: a fully functioning injury, where a small number of muscle fibres are torn resulting in some pain.
Grade 2: a moderate loss of function occurs, as a significant number of muscle fibres are torn.
Grade 3: all muscle fibres are ruptured resulting in major loss of function.
The way the tear is diagnosed is through testing the muscle strength, generally speaking the weaker the muscle is the less muscle fibres are still a attached. The best way of testing it is through Musculoskeletal ultrasound

-> (external) Shoulder Impingement syndrome:

One of the rotator cuff’s tendons often becomes pinched between the 2-bones that make up the shoulder joint. If this tendon or a close by bursa (called subacromial bursa) causes “pinching” it is called external impingement.

– Labral tear

The labrum is the cup that hugs round our arm bone (humerus). It supports and stabilise our shoulder. Like any soft tissue it can get damaged. Athletes who do a lot of overhead activity, such as swimmers, tennis players or gymnasts are more likely to damage their Gleno-humeral labrum/capsule. Dislocation of the shoulder joint is an extreme example of shoulder capsule damage, which often results in long-lasting instability.

 – Adhesive capsulitis

The other end of the spectrum is where the shoulder capsule develops adhesions, in essence glueing the shoulder tight. Commonly referred to as frozen shoulder, it is a condition which mostly effects 40-50 year olds, characterised by a shoulder that cannot reach overhead very high. It usually takes 6-months to pass but can take 3-months with frequent treatment and exercise.

– (internal) shoulder impingement

Sometimes part of the shoulder capsule pinches. This pinching is called impingement, and is characterised by a sharp pain when the shoulder is in a particular position. When the “pinching” occurs deep within the shoulder joint itself it is called internal impingement. Overtime this can develop into osteoarthritis:
 osteo (bone) arth (joint) itis (inflammation).
Adam has diagnosed and treated hundreds of conditions, through the following, research-backed treatment methods:
– Osteopathy
– Deep Tissue Massage
– Rehabilitative exercise prescription
– Reactive Neuromuscular training
– Fascial Manipulation
If you want a full assessment, to ascertain about what is causing you this pain. Then click here to contact Adam, to book your diagnosis and first treatment.
A prospective study of shoulder pain in primary care…. Cadogan, 2011

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