Reached for your coffee this morning and all of a sudden there is a sharp pain in your shoulder and you cannot move your shoulder in any direction without pain? Welcome to shoulder pain.

So why is shoulder pain so prominent? Could there be a different reason? Well, yes there is. If there is no definite injury event or symptoms from an old injury, it is always important to look to biomechanics.

Biomechanics of the shoulder

The shoulder is a complex joint made up of three bones, namely the humerus (upper arm bone), clavicle (collar bone) and scapula (shoulder blade). Each of these has several muscular attachments which can affect the movement and alignment of each bone. Scapular dyskinesis (an alteration or deviation in the normal resting or active position of the shoulder blade during shoulder movement) can lead to shoulder instability and injury.

Rotator cuff injury

The rotator cuff is made up of four muscles – Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. They are used to stabilise the shoulder joint. Injury to the Rotator Cuff is one of the most common shoulder injuries. The muscles of the rotator cuff all originate from the scapula and attach to the humerus. The purpose of the rotator cuff is to stabilise the shoulder joint. Tightness in the rotator cuff can contribute to scapula dyskinesis.

Treatment for shoulder injuries

Your physiotherapist will carry out a thorough assessment in order to provide you with a treatment that is specifically tailored your condition and recommend a rehabilitation programme to assist in healing and prevent recurrence.

Treatment techniques may include:

  • joint mobilisation techniques to relieve pain stiffness in the shoulder and surrounding joints,
  • myofascial release to loosen up the fascia allowing for better movement and/or
  • massage of any tight muscles and neural gliding techniques as necessary.

As mentioned, each rehabilitation programme is individually tailored to the patient. Some of the therapy may include:

  1. stretches to improve muscle length
  2. scapular setting
  3. scapular proprioceptive exercises (awareness of where the shoulder blade is in relation to the body)
  4. exercises to improve glenohumeral (shoulder) joint stability and mobility
  5. general upper body strengthening.

Chat to Grethe Geldenhuys at our Paulshof Practice if you need some help with shoulder pain. You can complete an appointment form right here from this article.

References

  1. McClure, P., Tate, A. R., Kareha, S., Irwin, D., & Zlupko, E. (2009). A clinical method for identifying scapular dyskinesis, part 1: reliability. Journal of athletic training, 44(2), 160-4.
  2. Burn, M. B., McCulloch, P. C., Lintner, D. M., Liberman, S. R., & Harris, J. D. (2016). Prevalence of Scapular Dyskinesis in Overhead and Nonoverhead Athletes: A Systematic Review. Orthopaedic journal of sports medicine, 4(2), 2325967115627608. doi:10.1177/2325967115627608.
  3. Kibler WB, Sciascia A Current concepts: scapular dyskinesia. British Journal of Sports Medicine 2010;44:300-305.
  4. Han KJ, Cho JH, Han SH, Hyun HS, Lee DH. Subacromial impingement syndrome secondary to scapulothoracic dyskinesia. Knee Surg Sports Traumatol Arthrosc 2012; 20(10): 1958-1960.