Shoulder Injuries

Shoulder joint is the most movable joint in the body. The reason for this movement is a very small joint contact zone which means that your shoulder is quite unstable. To remain in a stable position, the shoulder must be anchored by muscles, tendons and ligaments.

In most cases, shoulder pain is due to weakness in the shoulder muscles or they are working in an uncoordinated manner. These abnormalities can be normalized after a quality assessment and injury-specific treatment.

The most common shoulder injuries include:

Rotator cuff syndrome

Most of the shoulder injuries and pain are related to rotator cuff muscles. Rotator cuff consists of four small muscles which stabilize and control shoulder movements on the shoulder blade. These muscles are vulnerable to rotator cuff tear, rotator cuff tendonitis and rotator cuff impingement related injuries. The common causes of these injuries are repetitive shoulder movements, overused muscles and poor biomechanics. Physiotherapy is usually the first line of treatment to reduce pain, inflammation and to restore proper movement pattern.  Shock wave therapy is very effective in treating rotator cuff related shoulder pain.

Frozen Shoulder

Frozen shoulder or adhesive capsulitis is the condition where the shoulder joint capsule becomes inflamed and stiff. It commonly presents in 40 to 60-year-olds and is more prevalent in women. The cause is still unknown, however there are some known predisposing risk factors which includes, diabetes, history of shoulder injuries, immobilization after shoulder surgeries, thyroid disease and other autoimmune diseases.

Frozen shoulder has three stages and each stage has different symptoms.

  1. Freezing: This stage is characterized by pain around the shoulder initially, followed by a progressive loss of movement.
  2. Frozen: In this stage, stiffness dominates the pain which leads to functional limitations.
  3. Thawing: During this final stage, the range of motion starts to go back to normal. This can take anywhere from 6 months to 2 years.

Physiotherapy can be helpful in all stages to promote speedy recovery.

Shoulder Dislocation/Instability

A shoulder dislocation happens when the ball of the upper arm bone (humerus) is forced out of the shoulder socket. The dislocation may be partial, where the ball is only partially out of the socket or it can also be a full dislocation, where the ball is completely out of the socket. The most common causes are fall on outstretched arm, sport injuries and road traffic accidents.

The first step of treatment is “closed reduction” usually performed at A&E where the healthcare provider puts the ball of the upper arm back into the socket. Followed by, wearing a sling to keep your shoulder in place for a few days to several weeks.

Shoulder rehabilitation starts once the pain and swelling have improved. At MoveFree Physio, our therapist will design an individualised exercise program to strengthen the muscles and to restore mobility.

Shoulder Labral Tear

The labral tear is one of the common injuries to the shoulder especially in athletes who require lot of overhead movements (volleyball players and baseball pitchers). The labrum is the cup-shaped rim of cartilage that lines and reinforces the ball and socket joint of the shoulder. It contributes to shoulder stability and, when torn, can lead to shoulder instability. There are two types of labral tears:

  • Traumatic labral tears: Usually occur because of a single incident, such as a shoulder dislocation or an injury from overhead head activity.
  • Nontraumatic labral tears: Most often occur because of muscle weakness or shoulder joint instability.

Minor labral injuries can be well managed by physiotherapy with strength and stability training. In severe tears, surgical treatment might be required.

Shoulder Bursitis

Bursa is a tiny, fluid-filled sac which helps to reduce friction between the bones. There are several bursae in the shoulder joint in that subacromial bursa is the most commonly inflamed bursa.  The causes of bursitis are overuse injuries, impingement of bursa, and other joint inflammatory conditions. Physiotherapy is usually quite helpful in treating bursitis to reduce pain and restoring normal function in the shoulder.