The most common causes of shoulder pain that we address in our office:
Rotator Cuff Injury: A group of four muscles and attached tendons that rest directly on the shoulder blade, the rotator cuff are responsible for stabilizing the shoulder joint by keeping the head of the upper arm bone firmly encased within the shallow socket of the shoulder. This is an exceptionally big task, and it places a tremendous amount of stress and strain on both the rotator cuff itself and the joint that it is designed to protect. Under constant and prolonged use, ranging from low-impact activities such as typing to high-impact activities such as weightlifting, these muscles will often become damaged and develop adhesion. Adhesion in the rotator cuff muscles will severely limit their strength and mobility. This condition is particularly common in people who repeatedly perform overhead motions on the job (think carpenters and painters) or during athletic activities (think basketball players and tennis players). The defining characteristic of a rotator cuff injury is a dull ache deep in the shoulder. Other symptoms of rotator cuff injuries include general arm weakness and disturbed sleep, particularly when lying on the affected shoulder.
Shoulder Impingement: A general term that covers all irritation of the rotator cuff tendons that arises as a result of chronic and repetitive compression, shoulder impingement can cause considerable pain and a range of restricted movement issues. These symptoms typically grow at a slow rate over an extended period of time. The pain associated with shoulder impingement is generally localized at the front and side of the shoulder joint. The condition is particularly aggravated by repetitive motions that require one or both arms to be lifted overhead. Many point to the acromion process (or shoulder blade) as the main cause of shoulder impingement. Although the acromion can constrict rotator cuff tendons and cause them to become irritated, this is not usually the entire picture. Most often, the reason that these tendons become irritated is that they have been overused to the point of adhesion. Adhesion in the rotator cuff muscles makes them weaker and less flexible, which in turn stresses the rotator cuff tendons.
Shoulder Bursitis: Bursas are tiny fluid-filled sacs that provide cushion and function as gliding surfaces to reduce friction between tissues of the body. When the bursa in the shoulder joint becomes inflamed, it leads to a condition called shoulder bursitis. A classic indicator of overuse of the muscles that attach to the shoulder, this inflammation can arise as a result of injury, infection, or an underlying rheumatic condition. Most often, the damage that engenders shoulder bursitis is the result of adhesion, or a drastic tightening and/or glue-like sticking, in the rotator cuff muscles. Bursitis is generally defined by localized pain, tenderness, and/or swelling. These symptoms tend to become aggravated by any movement of tissue in the affected area.
Labrum/Muscle Tears: A cup-shaped layer of cartilage that lines and the ball and socket joint of the shoulder, the labrum is also the site of attachment for all inner-socket joint ligaments. Along with the four muscles and attendant ligaments of the rotator cuff, the labrum is responsible for reinforcing the entire shoulder joint area and ensuring that it is performing properly. When torn, both the labrum and the muscles of the rotator cuff can destroy shoulder stability and lead to partial or complete shoulder dislocation. In order to get to the root of the problem and begin the healing process in earnest, individuals with pre-existing tears in the shoulder labrum or rotator cuff muscles must first and foremost address issues of muscle adhesion. Finding and fixing adhesion will slow down the degenerative process and, if treated early enough, can delay or even eliminate the need for surgery.