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Easing Shoulder Pain: Understanding Causes and Embracing Rehabilitation

Welcome to Matrix Health and Performance's latest blog post, written by Dr Annie Xanthos (Osteopath).

This past month in clinic, Nick and myself have been seeing a lot of shoulder pain among our clients recently and we are seeing just how much it can significantly impact daily activity and quality of life.

Understanding the causes behind shoulder pain is the first step towards effective management and rehabilitation. Let’s dive into the top five causes of shoulder pain and five rehabilitative exercises to help you find relief. 

Top 5 Shoulder Conditions We See in Clinic

1. Rotator Cuff Tendinopathy

Rotator cuff tendinopathy occurs when the tendons of the rotator cuff muscles become irritated and inflamed. This condition can arise from acute injury or chronic overuse, leading to micro-tears within the tendon fibers. It often results from repetitive overhead activities, leading to pain and restricted movement. Over time, these repetitive stresses can exceed the tendon's ability to repair itself, resulting in inflammation and degenerative changes. The tendons most commonly affected are those of the supraspinatus muscle, which is vital for lifting the arm and stabilizing the shoulder joint.

Swinging a tennis racket, digging in the garden, placing a book on a high shelf, and reaching back to insert your arm into a sleeve — these are some of the movements made possible by the shoulder's enormous range of motion.

2. Bursitis

Bursitis of the shoulder involves inflammation of the bursae, which are small, fluid-filled sacs that act as cushions between bones and soft tissues, such as muscles and tendons. The subacromial bursa, located beneath the acromion (a bony projection on the scapula), is most frequently affected. Repetitive motion or prolonged pressure can lead to bursitis, causing the bursa to become inflamed and swell with more fluid, resulting in pain and restricted movement.

We often see patients who have trouble laying on their affected side when they sleep, present with shoulder bursitis!

3. Frozen Shoulder

Also known as adhesive capsulitis, frozen shoulder is characterized by stiffness and pain in the shoulder joint, caused by thickening and contracture of the joint capsule. It develops over time and can severely limit the range of motion.The exact cause is not fully understood but is believed to involve an abnormal response to inflammation, leading to fibrosis (scar tissue formation) within the shoulder capsule. This scar tissue tightens around the shoulder joint, restricting its movement. Frozen shoulder often develops in three stages: the freezing stage (painful and reduced motion), the frozen stage (stiffness but less pain), and the thawing stage (gradual return of motion).

4. Shoulder Impingement

Shoulder impingement syndrome occurs when the tendons of the rotator cuff muscles become compressed ("impinged") between the humeral head (top of the upper arm bone) and the structures of the shoulder blade, such as the acromion or the coracoacromial ligament. This impingement can lead to irritation, inflammation, and eventually, degeneration of the rotator cuff tendons. Repetitive overhead activities exacerbate this condition by narrowing the space through which these tendons pass, increasing the risk of impingement.

5. Osteoarthritis

Osteoarthritis (OA) of the shoulder occurs when the cartilage that cushions the ends of the bones in the joint deteriorates over time, leading to pain, stiffness and reduced mobility. As the cartilage wears away, it becomes frayed and rough, reducing its ability to protect and cushion the joint during movement. This degeneration can lead to bone rubbing against bone, causing pain, swelling, and decreased range of motion. Shoulder OA may be primary (age-related wear and tear) or secondary to other conditions or injuries that have damaged the cartilage

Stay tuned for our follow up piece in the next few days showcasing our favourite rehab exercises for the shoulder!

Dr Annie Xanthos (Osteopath)

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