Did you know the shoulder is the most complex and unstable joint in the body? Many use the analogy of a golf ball sitting on a tee when referencing the shoulder joint because of how shallow the interaction is between the two bones. Because of this inherent instability within the joint itself, it is very important to have the proper strength present to stabilize the joint and help decrease the risk of suffering from an injury.
Brief Anatomy
When referring to the shoulder, there are two types of stabilizers that we rely on; static and dynamic. The static stabilizers are the ones that are constant; these consist of the bones, ligaments, capsule, etc. The other type of stabilizers, dynamic stabilizers, are the muscles. With the shoulder joint, there are a significant number of muscles that responsible for proper movement and stability of the bones that make up the shoulder joint.
Potentially of most importance is the infamous rotator cuff. The primary function of the rotator cuff, when referring to the shoulder joint, is to promote increased stability by keeping the head of the humerus centered in the glenoid fossa. If the rotator cuff is weak, there is increased potential for the head of the humerus to move around, or “translate”, within the joint which can lead to a number of other pathologies.
Another very important factor for good shoulder health is both the strength of the shoulder blade, or scapular, muscles as well as good thoracic spine mobility. The glenoid fossa that was mentioned above is actually part of the scapula and that is what the arm bone, or humerus, articulates with to create the shoulder joint. If the scapula doesn’t have good stability and the proper forces acting on all aspects of it, it will lead to decreased mechanics and potential pathology within the shoulder joint.
Impingement Syndrome
Thus, if you are having shoulder pain, you can see how there could be a wide variety of potential causes and different treatment options. One of the most common shoulder pathologies is a diagnosis of “impingement syndrome”. This is essentially saying that there is not enough space between two surfaces in the subacromial area and, because of the decreased space, you are experiencing your painful shoulder symptoms. This is a condition that we treat frequently and one that responds well to therapeutic intervention.
If there is poor stability surrounding the joint, as previously discussed, there is the potential that there is an increased amount of translation present within the joint that can lead to irritation of the structures that are located in this small space and result in the painful shoulder symptoms. Frequently, motions that decrease the space in the subacromial area, such as reaching across your body or internally rotating your shoulder, will cause increased pain because it further decreases the available space in the subacromial area and leads to further irritation.
Come See Us!
At Align Therapy, we are able to successfully manage painful conditions of the shoulder and allow our patients to return to an improved quality of life. There are a number of different tests that we can perform in the clinic in attempt to identify the source of the shoulder pain being experienced. Based on the findings of these tests, we are able to guide you in the right direction to resolve the shoulder pain; whether it be creating a personalized plan of care for you to participate in with the physical therapist, lifestyle modifications that may be exacerbating the shoulder symptoms, or following up with a doctor to further investigate the cause of the pain and potentially have diagnostic imaging performed. At the end of the day, our goal is to assist you, the patient, with decreasing their painful symptoms and returning to an improved quality of life.
Personally, I thoroughly enjoy treating shoulder pathologies due to having had three shoulder surgeries myself. I find the dynamic nature of the shoulder very interesting and enjoy working with my patients to mitigate the painful symptoms they’re experiencing to allow for returning to the activities they enjoy. In addition, I really enjoy educating patients on why they are experiencing the symptoms they are and what we can do to successfully decrease the symptoms.
So, if you are having shoulder pain and want to get to the bottom of it, call today and let me assist you with this pain and returning to the activities that you’re missing because of this pain.
Author: Court Zollinger, DPT
Physical Therapist
