Is that niggle in your shoulder continuing to get worse? Is the pain after an accident not going away? Are you noticing you can’t reach up into cupboards or wash your hair without pain? Shoulder problems are the second most common condition we treat here at Thorpes Physiotherapy (behind Back pain). Shoulder pain can be debilitating and affect multiple aspects of everyday life, but what could be the cause of that pain? In this post, we will discuss the main anatomy of the shoulder to help with your understanding of shoulder pain.
Bones
The shoulder joint is made up of three main bone structures – the clavicle (collarbone), scapula (shoulder blade) and humerus (upper arm bone). Parts of the scapula also come through to the front of the shoulder – the coracoid process and acromion. These all form the ball and socket structure of the shoulder, which allows for the extensive range of movement. However, the part of the scapula that forms the socket, or the glenohumeral joint, (the glenoid) is quite shallow for the humerus. Therefore, we need the ligaments and muscles to help keep everything in place and working as efficiently and effectively as possible.
Ligaments
There are many ligaments in your shoulder to keep all the bones in place. The main ones form the shoulder capsule and are called the Glenohumeral Ligaments. There are three in total – superior, middle and inferior. They are responsible for keeping the humerus in place and can be damaged in a dislocation.
Muscles
You may have heard of the Rotator Cuff muscles. They are 4 small muscles that sit around the shoulder and allow the arm to move and do all the activities you enjoy. Supraspinatus sits at the top of the shoulder blade and is responsible for taking your arm out to the side (it is also the most commonly injured). Infraspinatus lies towards the bottom of the shoulder blade and rotates the arm outwards, along with Teres Minor. Subscapularis is underneath the shoulder blade and rotates the arm inwards.
When your physiotherapist mentions the Rotator Cuff, whether it be a tear or tendinopathy, they will be referring to the muscles above. Rotator Cuff issues can result in pain, reduced arm movement and impact on sports and daily activities, such a putting plates in a cupboard.
Other shoulder muscles include Teres Major and Deltoid. The Deltoid fibres are responsible for taking your arm out to the side and forwards. This becomes an integral feature of rehab as we can train these fibres to assist movements whilst other muscles recover.
Nerves & Blood Supply
All muscles are supplied by nerves and the rotator cuff are no different! They are mainly innervated by the upper and lower Suprascapular nerve and the axillary nerve. These two nerves originate from the 5th and 6th level in your neck. Because of this, your physiotherapist will always check your neck over in the examination to ensure your pain is not originating from your neck.
Common Injuries
Some common shoulder issues you may have heard of include Rotator Cuff Tears, Rotator Cuff Tendinopathy and Frozen shoulder. These will be diagnosed based on your history, mechanism of injury, your range of movement and strength and the pain you are experiencing.
Physiotherapy can be effective for the majority of shoulder conditions and is something we treat at lot here at Thorpes. Physiotherapy is something that GP’s and Orthopaedic Consultants frequently recommend before ordering x-rays, scans, giving injections or considering surgery.
If you or someone you know is currently suffering with a shoulder problem and would like some help, please get in touch. You can either call the clinic on 01276 37670 to book in OR if your not sure if Physiotherapy is the best thing for your shoulder, why not request a FREE Discovery phone call or find out more information by clicking here. You can also book online by clicking the button below.
I hope you have found this interesting
Warm regards
Jess Metcalfe
Physiotherapist at Thorpes Physiotherapy