Shoulder Injuries

The shoulder is actually a complex group of four joints. 

Shoulder Injuries Overview

The shoulder is actually a complex group of four joints. It is one of the most mobile structures of our body however its great mobility predisposes it to injury and instability. All of the muscles, tendons, ligaments, and joints must function in the right proportions and at the right time otherwise breakdown and overuse can occur resulting in injury. Problems of the shoulder are often very difficult to compensate for without significant limitation in normal daily function making it one of the most commonly treated joints by physical therapists.

Shoulder pain may result from a variety of causes including a falling injury, straining to reach an object, lifting something heavy, or throwing a ball. The majority of shoulder pain and problems are a result of gradual irritation over time. This may be due to repetitive use of the arm, poor posture causing stress on the shoulder, or muscle imbalances where certain structures of the shoulder become either too weak/strong or too tight/loose. If left untreated, minor irritations in the shoulder often lead to greater problems over time.

Common Causes of Shoulder Pain

Bursitis

Bursitis is an irritation or inflammation of the fluid filled sack or “bursa” that cushions the tendons in joints. When the bursa becomes irritated the shoulder may become painful and stiff.

Common Causes of Shoulder Bursitis:

  • Gout
  • Hard blow to tip of elbow
  • Infection of bursa caused by bite, scrape or wound
  • Repetitive and prolonged motion or pressure
  • Rheumatoid arthritis
  • Trauma
  • Long periods of pressure on joint—leaning upon the arm or elbows

Common Signs and Symptoms of Shoulder Bursitis:

  • Aches
  • Pain (especially when applying pressure)
  • Redness and warmth (may indicate infection)
  • Restricted movement
  • Stiffness
  • Swelling
Rotator Cuff Tear

The rotator cuff is a group of four muscles that surround the shoulder joint and are integral in providing the necessary stability of the shoulder while contributing to its mobility as well. This is a commonly injured region of the shoulder and can be damaged in several ways. Injuries can range from strains and tendonitis, to tears.

Common Causes of Rotator Cuff Tears:

  • Degenerative conditions such as arthritis
  • Direct blow
  • Fall
  • Repetitive overhead motion
  • Sports-related injury
  • Trauma

Common Signs and Symptoms of Rotator Cuff Tears:

  • Clicking
  • Limited range of motion
  • Pain:
    • Constant
    • Recurrent
    • Nighttime
  • Popping
  • Weakness
Labrum Tear

A labrum tear refers to a tear in the cartilage surrounding the shoulder socket. A tear like this often results in pain as well as a feeling of instability in the shoulder

Common Causes of Labrum Tears:

  • Acute injury
  • Aging

Common Signs and Symptoms of Labrum Cuff Tears:

  • Aching
  • Catching
  • Grinding
  • Limited range of motion
  • Pain (especially shoulder, arm)
  • Popping
  • Sensation of “looseness”
  • Weakness
Arthritis

Arthritis of the shoulder is particularly debilitating. Pain and related stiffness and weakness often results in limited use of the joint thereby resulting in even greater range of motion loss and weakness.

Common Causes of Shoulder Arthritis:

  • Accident
  • Fracture
  • Natural wear-and-tear (loss of joint cartilage)
  • Repetitive stress
  • Sports injury
  • Aging

Common Signs and Symptoms of Shoulder Arthritis:

  • Grating
  • Hard lumps or bone spurs
  • Limited range of motion
  • Pain
  • Stiffness
  • Tenderness
Impingement

Impingement of the shoulder refers to a narrowing of the space between a portion of the shoulder blade and the arm bone (humerus) often resulting in inflammation and, in more significant cases, tendinitis or bursitis.   Impingement can develop for several different reasons.

Common Causes of Shoulder Impingement:

  • Frequent overhead activity
  • Bone spurs occurring in the shoulder girdle
  • Muscular imbalances

Common Signs and Symptoms of Shoulder Impingement:

  • Limited range of motion
  • Pain (particularly when reaching overhead or to the side)
  • Weakness
  • Tenderness
Frozen Shoulder

Sudden pain, stiffness, or loss of motion in the shoulder could be a condition called frozen shoulder, or adhesive capsulitis. Although the cause of this condition is largely unknown, there are treatment options that can relieve symptoms more quickly.

Common Causes of Frozen Shoulder:

  • Unknown (more common in the middle-aged, women, and in diabetics)

Common Signs and Symptoms of Frozen Shoulder:

  • Decreased range of motion
  • Pain
  • Stiffness

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