Shoulder Pain

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Injuries to the shoulder joint are very common, particularly amongst athletes participating in overhead activities. Shoulder injuries are also very common amongst the general population and recreational gym goers, accounting for 13% of chronic pain suffered by Irish patients (1). In fact, 40% of general population and recreational gym goers still experience shoulder pain as long as 12 months following the initial incident (2) - highlighting the importance of early diagnosis and efficient rehabilitation.

The shoulder joint is a ball and socket joint. This allows the shoulder (and thus, the arm) to move through a large range of motion to accommodate tasks of daily living. There are also numerous structures running through and around the shoulder joint - muscles, tendons, ligaments, nerves and vascular structures - which may contribute to the shoulder pain experienced by patients. The bony structures comprising the joint may also contribute to the development of pain in the region, particularly in elderly patients.

Sub Acromial Impingement Syndrome is a common clinical condition of the shoulder joint. This essentially involves a reduction in the movement capacity of the joint, leaving the patient with a decreased range of motion accompanying pain. A common causative factor for impingement includes a high load of overhead activities leading to thickening of the tissues underneath your acromion which results in impingement style symptoms, but other factors may also predispose a person to this condition.

Rotator cuff injuries are also common in the shoulder joint. The rotator cuff is a group of four muscles, helping to both produce and control movement of the shoulder girdle. Strains to these muscles can occur, due to a high loading relative to the tissue strength. Tendinopathies may also develop, which can cause long term movement dysfunction if not diagnosed and rehabilitated as soon as possible (3).

Reducing the risk of shoulder joint injuries can be achieved by identifying imbalances early, starting a graded rotator cuff strengthening programme and improving scapular control to optimise function of the shoulder girdle.

1. Raftery, M. N., Sarma, K., Murphy, A. W., De la Harpe, D., Normand, C., & McGuire, B. E. (2011). Chronic pain in the Republic of Ireland—Community prevalence, psychosocial profile and predictors of pain-related disability: Results from the Prevalence, Impact and Cost of Chronic Pain (PRIME) study, Part 1. Pain, 152(5)
2. Winters, J. (1999). The long-term course of shoulder complaints: a prospective study in general practice. Rheumatology, 38(2), 160–163.
3. Seitz, A. L., McClure, P. W., Finucane, S., Boardman, N. D., & Michener, L. A. (2011). Mechanisms of rotator cuff tendinopathy: Intrinsic, extrinsic, or both? Clinical Biomechanics, 26(1), 1–12.