Shoulder Rehab

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Overview

The shoulder is made up of several joints that combine together with tendons and muscles to allow a wide range of motion in the arm. This wide range of motion may lead to problems with instability or impingement of the soft tissue or bony structures in your shoulder, often resulting in pain. Your rotator cuff is one of the most important structures in your shoulder to provide mobility and stability. The rotator cuff is made up of four small muscles and their tendons that cover the head of the upper arm (humerus) and keep it in the shoulder socket.

Anatomy

Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).

The head of your humerus fits into a rounded socket in your shoulder blade. This socket is called the glenoid. A combination of muscles and tendons keep your humerus centered in your glenoid. These tissues are called the rotator cuff, and they cover the head of your humerus and attach it to your scapula.

Symptoms

 You may only feel pain with certain movements, or all of the time. The pain may be temporary or it may continue and require medical diagnosis and treatment. 

Common Injuries

Most shoulder problems fall into four major categories:Tendon inflammation (bursitis or tendonitis) or tendon tear, instability, arthritis, fracture (broken bone)


  • Bursitis- Bursa are small, fluid-filled sacs that are located in joints throughout the body, including the shoulder to act as cushions between bones and the overlying soft tissues to help reduce friction between the gliding muscles and the bone. Excessive use of the shoulder may lead to inflammation and swelling of the bursa, most commonly the subacromial bursa. Bursitis often occurs in association with rotator cuff tendonitis. Many daily activities, such s combing your hair or getting dressed, may be painful.
  • Tendonitis- Tendons are thick, fibrous cords that connect muscle to bone. Most tendonitis is a result of a wearing down of the tendon that occurs overtime. The most commonly affected tendons in the shoulder are the four rotator cuff tendons and one of the biceps tendons. 
  • Tendon tears- Splitting or tearing of tendons my result from acute injury or degenerative changes in the tendons due to aging, long-term overuse, wear and tear, or sudden injury. These tears may be partial or may completely split the tendon. In most cases of complete tears, the tendon is pulled away from its attachment to the bone. Rotator cuff and biceps tendon injuries are among the most common of tendon tears in the shoulder.
  • Impingement- Shoulder impingement occurs when the top of the shoulder blade (acromion) puts pressure on the underlying soft tissues when the arm is lifted away from the body. As the arm is lifted, the acromion rubs, or “impinges”, the rotator cuff tendons and bursa. This can lead to bursitis and tendonitis, casing pain and limiting movement. Over time, severe impingement can lead to rotator cuff tear.
  • Instability- Shoulder instability occurs when the head of the humerus (upper arm) is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse. Shoulder dislocations can be partial, called a subluxation, or complete. Once the ligaments, tendons, and muscles around the shoulder become loose or torn, dislocations are more likely to occur. Repeated episodes of subluxation or dislocations lead to an increased risk of developing arthritis.
  • Arthritis- This is the most common type of arthritis, sometimes called degenerative arthritis. It’s a wear-and-tear condition that occurs when the cartilage in your shoulder deteriorates with use and age. This causes the bones of the joint to rub more closely against one another. The rubbing my result in pain, swelling, stiffness and decreased ability to move. Osteoarthritis symptoms can usually be effectively managed through conservative treatments such as physical therapy, although the underlying process cannot be reversed.
  • Fracture- Fractures are broken bones. Shoulder fractures commonly involve the clavicle (collarbone), humerus (upper arm bone) and scapula (shoulder blade). Shoulder fractures in older patients are often the result of a fall. Shoulder fractures in the younger population are often caused by a high-energy injury, such as a motor vehicle accident or contact sports injury. 


Treatment

A thorough physical examination will usually establish the diagnosis of shoulder pain and guide your individualized shoulder rehab or sports rehab. The underlying cause of shoulder pain will help direct the treatment and plan of care. Most instances of shoulder pain can be successfully treated conservatively (physical therapy, chiropractic, massage, etc.) although some injuries may require surgerical intervention.


Source: https://orthoinfo.aaos.org


Shoulder Pain

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New Wave Physical Therapy & Sports Rehabilitation

7125 Turner Road, Rockledge, Florida 32955, United States

P: (321) 961-3805 (call/text) F: (321) 362-4678

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