The shoulder is one of the most mobile joints in the body! As a result, it can be very vulnerable to traumatic injuries such as dislocations, joint sprains and soft tissues injuries. These kind of injuries may occur in collision and contact sports. However, they can also occur from repetitive overuse mechanisms such as sports that involve repeated overhead throwing.
One of the most shoulder injuries is rotator cuff tendinopathy. The rotator cuff is a group of four muscles and tendons create a covering around the head of your upper arm bone (humerus) stabilising the shoulder joint. With repeated movements these tendons can become inflamed and if untreated can lead to a break down in the rotator cuff.
Patients with this condition may complain of pain with overhead movements such as in throwing, swimming and tennis. In most cases, activities that involve shoulder elevation less that 90degrees are pain free. During examination, there may be tenderness upon palpation of the surrounding shoulder structures. Special tests which stress specific tendons of the rotator cuff can be used to inform us of which tendon is affected. In some cases, an ultrasound can be recommended to rule out a tear of the rotator cuff (which is something we will advise you on).
Treatment is divided in two parts. The first part consists of reducing pain and inflammation. Activities that increase the pain should be avoided and ice should be used. We use manual hands on techniques to reduce pain and promote healing. This may include soft tissue release of the shoulder capsule, moving and gapping the shoulder joint, thoracic spine and acromioclavicular joint (which is one of the joints in the shoulder girdle).
The second part of treatment involves strengthening exercises of the rotator cuff muscles. These exercises target the specific rotator cuff muscles and will be progressed gradually. You will be given a comprehensive exercise program which addresses all the strength deficits in your shoulder. The image below is just a basic example of what to expect.
The final phase is performing a comprehensive biomechanical assessment, which consists of video analysis of your whole body movements so that we can find any other factors in your body that may have caused your shoulder injury. The ultimate goal of this is to develop a tailored program to not only reduce the likelihood of this shoulder injury and/or pain coming back again but to get you back into what you love doing!
This is just a general guide of what can be done for a shoulder. Every elbow and person is different so for more personalised information and advice, please call (02) 9870 0250 and one of our physiotherapists will be happy to provide a complementary phone consultation.
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