Common Causes of Shoulder Pain

The shoulder is an amazing joint.  We have the ability to move our shoulders in many different directions.  Shoulder mobility is great if you have to reach for something, but there is a cost to this mobility: the shoulder is more prone to injury.

Shoulder injuries are very common and can usually be traced back to some repetitive arm movement which involves overhead or reaching activity.  As Physical Therapists we often see patients who was playing tennis or painting developing shoulder pain.  Also, a simple activity that most of us do every day is reaching for a mouse while typing at a computer.  Over time, this can also lead to shoulder pain.  Eventually common daily activities become painful such as:  putting on a shirt, putting on a jacket, reaching back to tuck in a shirt, and sleeping on the shoulder.

Although there are many reasons for shoulder pain, the more common include:  shoulder impingement, rotator cuff tendonitis, and rotator cuff tears.

Maintenance of the sub-acromial space is important with shoulder movements and function.  The sub-acromial space is where the humerus articulates with the scapula and clavicle. When the space is narrowed, pathology of impingement and rotator cuff tendonitis/tears may occur. When the tendon is irritated by stretching or compression, this can cause tendonitis, and literally means inflammation of the tendon.

Posterior (back) structures

Chronic changes in these tissues can cause tears in the tendon.

Common contributing factors of shoulder pathology include poor body posture,  poor form with exercise, and weakness in the rotator cuff musculature.

With improved posture, proper exercise training, and rotator cuff strengthening, shoulder injuries can be prevented.

Body posture can affect the position of the shoulder joint.  In a slouched position the space under your shoulder joint is limited and may lead to the rotator cuff impingement, which can lead to rotator cuff tendonitis.  Slouching at computer and then reaching for a mouse that’s too far away, can lead to shoulder pain.  Over time, this can lead to chronic rotator cuff tears and shoulder pain.  So, there’s another reason for sitting up straight and using proper ergonomics!!!

Poor exercise form and weakness in the rotator cuff musculature
A proper training routine for a balance in strength on all sides of the shoulder is important.  Often, the upper back shoulder muscles and rotator cuff muscles are neglected in an exercise routine. The rotator cuff muscles play an important role for the stabilization of the shoulder joint. This is especially important for sports that involve overhead movements.  For example:  with tennis, holding the tennis racquet while hitting overhead and with baseball, the repetitive throwing motion.  Both movements are powerful and require good shoulder mobility and stability.

Anterior (front) structures

If the anterior muscles are over developed and tight (pectoralis), the position of the shoulder joint is adversely effected by a decreasing space under the sub-acromial space.  This may lead to impingement and rotator cuff pathology.

A balanced routine is important for a healthy shoulder.  The muscles that stabilize the back help with the position of the shoulder blade for optimal space under the sub-acromial joint. Also strengthening the rotator cuff muscles specifically can help with the stability of the shoulder joint.

Stay tuned for next week for videos and explanation on exercises for a healthy, balanced shoulder.


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