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  • Shoulder Pain

Shoulder Pain

Frozen Shoulder

Adhesive capsulitis, or frozen shoulder, is a condition in which the shoulder cannot be moved normally due to pain and inflammation in the joint capsule of the shoulder. Limited range of motion not only occurs when the individual tries to move the shoulder, but even if shoulder movement is forced. The condition may arise due to no known cause other than lack of use of the shoulder joint.

Frozen shoulder is caused by inflammation, scarring or thickening that occurs within the capsule of the shoulder joint. The capsule of ligaments in the shoulder joint allows the bones in the shoulder to freely move within the joint and if this becomes inflamed, the bones in the shoulder may have difficulty moving or may not be able to move at all. In many cases, there is no known cause for the inflammation and the condition arises from lack of use of the shoulder joint, but some causes that can lead to the condition include diabetes, shoulder trauma or injury, shoulder surgery, tendonitis, bursitis, cervical disc disease, chronic inflammatory arthritis, hyperthyroidism or any type of surgery located in the chest or breast.

Bicep Tendonitis/Bursitis

The terms shoulder tendonitis and shoulder bursitis are often used to indicate that there is inflammation within the shoulder joint, either to the tendons of the rotator cuff or the bursa, the fluid filled sac surrounding the tendons. As the tendons and bursa become inflamed, they thicken and it becomes more difficult to move the shoulder joint without pain and stiffness. The cause and symptoms of these conditions are the same as those of shoulder impingement, since they are caused by an impingement of some kind within the shoulder joint.

Shoulder tendonitis or bursitis is often caused by repetitive overhead activities, such as those found in some sports (swimming, tennis, cricket) or occupations (painting, construction). The condition, however, can be caused by anything that causes impingement in the shoulder joint, such as a bone spur or direct injury to the shoulder. Other conditions such as arthritis, gout, infection or diabetes may also cause inflammation. The conditions are more likely to occur as a person ages, since the tendons become less flexible and more prone to inflammation.

Rotator Cuff Pathology

The rotator cuff consists of four muscles that connect the bones in the shoulder, namely the humerus (upper arm) and the scapula (shoulder blade). Injury can occur to any one of the four muscles or to multiple muscles simultaneously, and can be the result of an acute injury that occurs suddenly or a chronic condition that repeatedly aggravates the area and causes pain and diminished mobility. When the rotator cuff is injured, it can result in anything from occasional pain and inflammation to a complete tear of the muscle, impeding movement of the arm. Depending on the cause and severity of the injury, treatment may vary widely.

Since the rotator cuff is the main set of muscles that control movement of the arm, there are numerous situations that can cause injury to the area. Rotator cuff injuries can occur suddenly, and in this case the injury is considered acute. These are usually the result of a severe force resulting from a fall, lifting a heavy object, or moving the shoulder or arm suddenly in such as a way as to cause a trauma to the muscles. Rotator cuff injuries can also be more chronic in nature, resulting from repetitive or excessive movements that weaken the muscle structure over time, or can be the result of a degeneration of the muscles that can occur as a person ages.Injury to the rotator cuff can also be caused by tendonitis.Rotator cuff injuries are seen more often in men above the age of 40 (although tendonitis is more often seen in women), but can occur in anyone at any age, and injuries to the rotator cuff are more commonly seen in those with professions or hobbies that require repetitive shoulder movements.

Shoulder Impingement

Shoulder impingement occurs when pressure is placed on the rotator cuff from part of the shoulder blade when the arm is lifted. The tendons of the rotator cuff become compressed between the shoulder blade and the humerus (upper arm bone), causing inflammation (leading to tendonitis or bursitis) that can lead to pain, stiffness, tenderness, limited mobility and even a torn rotator cuff. Shoulder impingement is the leading cause of shoulder pain.

Shoulder impingement is caused by a portion of the shoulder blade pressing on the rotator cuff when the arm is lifted. The rotator cuff is a set of tendons that connect four main muscles in the shoulder, allowing an individual to rotate and lift the shoulder. Compression is typically caused by either a bone spur that rubs or pinches the tendons or an inflammation of the bursa, the lubricating sac that surrounds the rotator cuff. Impingement of the rotator cuff is most likely to occur in individuals that spend a lot of time with their arms stretched overhead or that do repetitive heavy lifting, including athletes, such as swimmers and cricket players, as well as those in certain professions, such as construction or painting.

Shoulder Instability

Chronic shoulder instability occurs when loose ligaments within the shoulder joint make it more likely that the humerus (upper arm bone) will repeatedly dislocate or slip out of place from the shoulder socket.This can be due to an initial dislocation of the shoulder that causes ligaments, tendons, or muscles within the shoulder joint to become stretched or torn, or can be the result of repetitive strain on the joint.
In many cases, a severe dislocation of the shoulder can result in chronic shoulder instability. This is due to the fact that when the initial dislocation occurs, it can tear or stretch the ligaments in the front of the shoulder. When this occurs, the shoulder can feel unstable or can occasionally slip out of place partially or fully. Shoulder instability can also occur without an initial trauma occurring to the shoulder joint. Repetitive overuse involving overhead activities, such as those seen in some sports (swimming, tennis, baseball) or occupations (painting, construction) can lead to a loosening of the ligaments in the shoulder, making the shoulder feel unstable. A condition known as multidirectional instability, in which a person naturally has loose ligaments throughout their body, can also cause the shoulder to be unstable or can result in dislocations of the joint occurring in any direction.

Shoulder Sprain / Strain

A shoulder sprain or strain involves an injury to the soft tissues of the shoulder. Sprains involve injury to ligaments (the bands of tissue that connect bones together) and strains refer to injuries of muscles and tendons. Shoulder sprains occur in one of the joints that connect the four bones of the shoulder – the clavicle, sternum, scapula and acromion. Severe sprains can cause shoulder separation.Shoulder strains can be relatively minor or can result in a complete tear of muscle.

Most shoulder sprains occur when the arm is unnaturally forced to twist, the arm twists suddenly or abruptly, an individual falls on an outstretched arm, or there is a severe direct blow or trauma to the arm, shoulder, or upper chest. Shoulder sprains are common in individuals that engage in contact sports. Shoulder strains can result from poor posture, keeping the arms elevated or in an awkward position for a prolonged period, a quick or sudden movement, and even stress.

Shoulder Tendonitis / Bursitis

The terms shoulder tendonitis and shoulder bursitis are often used to indicate that there is inflammation within the shoulder joint, either to the tendons of the rotator cuff or the bursa, the fluid filled sac surrounding the tendons. As the tendons and bursa become inflamed, they thicken and it becomes more difficult to move the shoulder joint without pain and stiffness. The cause and symptoms of these conditions are the same as those of shoulder impingement, since they are caused by an impingement of some kind within the shoulder joint.

Shoulder tendonitis or bursitis is often caused by repetitive overhead activities, such as those found in some sports (swimming, tennis, baseball) or occupations (painting, construction). The condition, however, can be caused by anything that causes impingement in the shoulder joint, such as a bone spur or direct injury to the shoulder. Other conditions such as arthritis, gout, infection or diabetes may also cause inflammation. The conditions are more likely to occur as a person ages, since the tendons become less flexible and more prone to inflammation.

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