Introduction to common shoulder pain syndromes
Shoulder pain can arise from various sources, each presenting distinct challenges and symptoms. Understanding these major shoulder pain syndromes is crucial for timely intervention and effective management. Here's a brief overview of some prevalent shoulder pain syndromes.
Rotator Cuff Injuries
- Description: The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of the upper arm bone firmly within the shallow socket of the shoulder. Most injuries will compromise the tendons of these muscles, often creating some amount of tearing in the tissues that creates pain and inflammation. Depending on the severity of these injuries, surgery may be warranted, but rarely under our care and supervision.
- Symptoms: Typically described as a deep, dull ache in the shoulder. Pain is often worse when moving the arm overhead or reaching behind. Weakness and pain during sleep is also often associated with rotator cuff injuries.
- Causes: Rotator cuff injuries are common and increase with age. These injuries may occur earlier in people who have jobs that require repeatedly performing overhead motions, such as painters and carpenters. We see most rotator cuff injuries in our office are a result of previous sports injuries, repetitive overhead lifting/throwing, and traumatic falls where the arm is in an awkward or unstable position.
Shoulder Impingement Syndrome
- Description:Occurs when the rotator cuff tendons or bursa are compressed during arm movements, leading to irritation and pain. This can be similar to a rotator cuff injury (technically it is the rotator cuff) and can lead to further tearing or fraying of the muscles/tendons without intervention. Most people can work through these injuries without the pain being too limiting and they can also resolve fairly quickly with the right strategies.
- Symptoms: Pain or pinching feeling in the shoulder that is felt with moving the arm overhead. Pain can also be felt with exercises like push ups, bench press, overhead press, and lateral/front raises.
- Causes:Repetitive overhead activities, aging, or anatomical factors. Most often it's a combination of poor exericse/movement technique coupled with overuse. In some cases, there is a genetic deformity of the acromion that decreases the space for these tissues to move, thus creating a pinching sensation when moving overhead.
Tendinitis and Bursitis
- Description:Occurs when the rotator cuff tendons or bursa are compressed during arm movements, leading to irritation and pain. This can be similar to a rotator cuff injury (technically it is the rotator cuff) and can lead to further tearing or fraying of the muscles/tendons without intervention. Most people can work through these injuries without the pain being too limiting and they can also resolve fairly quickly with the right strategies.
- Symptoms: Pain or pinching feeling in the shoulder that is felt with moving the arm overhead. Pain can also be felt with exercises like push ups, bench press, overhead press, and lateral/front raises.
- Causes:Repetitive overhead activities, aging, or anatomical factors. Most often it's a combination of poor exercise/movement technique coupled with overuse. In some cases, there is a genetic deformity of the acromion that decreases the space for these tissues to move, thus creating a pinching sensation when moving overhead.
Periscapular Pain
- Description:Periscapular pain refers to discomfort in the region around the scapula (shoulder blade). It can manifest as localized pain or radiate to nearby areas, affecting daily activities and shoulder function.
- Symptoms:Persistent or intermittent pain in the periscapular region, discomfort exacerbated by certain shoulder movements and/or posture, sensitivity or tenderness in the muscles around the scapula.
- Causes: Overuse or strain of the muscles supporting the scapula, poor posture, poor respiration, muscular imbalance/lack of coordination, referral from the cervical spine.
Scapular Winging/Dyskinesis
- Description: Scapular winging/dyskinesis refers to an abnormal positioning or movement of the scapula (shoulder blade). Instead of lying flat against the rib cage, the scapula may protrude or tilt, disrupting the normal mechanics of shoulder movement.
- Symptoms: Noticeable protrusion or winging of the scapula, especially during certain arm movements, pain or discomfort in the shoulder or upper back region, impaired ability to perform certain shoulder movements or pain with loading of the upper extremity.
- Causes: Weakness or imbalance in the muscles around the scapula, dysfunction of the nerves controlling scapular movement, prolonged poor posture, poor stereotype for respiration and stabilization of the spine.
Conclusion
You have completed the common shoulder injuries module for this course! I hope that by now you have an understanding of how the functional anatomy and biomechanics of the shoulder can play into common shoulder injuries. Move forward to see the rehab exercises we use in our office to correct these issues.
