Shoulder pain? What are the different types of shoulder pain? When should I consult an osteopath for my shoulder?
Shoulder pain
Shoulder osteoarthritis
Omarthrosis, also known as osteoarthritis of the shoulder. Omarthrosis refers to damage to the cartilage of a joint between two bones. The joint concerned is the one comprising the shoulder blade and the upper end of the arm, known as the head of the humerus. Worn cartilage in the glenohumeral joint leads to shoulder pain, as the two bones come into contact.
Symptom :
- Variable, intermittent shoulder pain due to inflammation.
- Pain when moving the shoulder (especially when rotating)
- Temporary blockages of the shoulder joint.
- Cracking sensations.
- Progressive stiffening of the joint.
Rotator cuff tear
Rotator cuff tear refers to damage to one or more shoulder tendons.
There are 3 types of cuff tears:
- Due to natural wear and tear of tendons with age
- Traumatic rupture following trauma
- Trophic rupture, which may be the result of a false move or a simple, harmless gesture.
Symptoms: Shoulder function is impaired, resulting in limited movement.
Subacromial shoulder conflict
It corresponds to abnormal friction between the acromion and the upper part of the humerus. It occurs mainly when lifting at shoulder height, i.e. 90° anterior elevation or abduction.
This is a frequent cause of consultation for anterior shoulder pain.
Diagnosis: on clinical examination, we look for painful hooking felt when the head of the Humerus comes into contact with the acromion.
Treatment: 2 arms pressed to the body, hands holding a cane horizontally in front of you. Without any movement, alternately push and pull as if to lengthen or compress the cane, in 10-second sequences.
Slap shoulder injury (arm tear)
This involves damage to the upper part of the Labrum and the associated tendon. The Labrum is torn and there is an associated rupture of the long Biceps tendon.
Symptoms :
- Mild to moderate pain during certain shoulder movements.
- Sensation of discomfort inside the shoulder.
- Snapping sensation.
- Shoulder more or less unstable.
- Loss of shoulder and arm strength.
- Loss of speed when throwing.
Retractile capsulitis=frozen shoulder
Retractile capsulitis is an inflammation of the shoulder capsule.
Dominant symptoms :
- Permanent shoulder pain.
- Joint stiffness.
- Disappearance of rigidity, then reappearance of shoulder mobility.
Causes: severe fatigue, stress, local trauma such as a fall.
Treatment: immobilization by splint or plaster cast.
Calcific tendinopathy tendinopathy
Cause: Calcium accumulation within one of the rotator cuff tendons.
Often observed in adults between 30-50 years of age.
Symptoms: calcific tendinopathy of the shoulder manifests itself as inflammatory pain, which is often inseminating and may be exacerbated when calcification appears or disappears. The first course of treatment is analgesics and anti-inflammatories.
Shoulder dislocation and instability
Acromioclavicular dislocations are the result of sports accidents, as well as accidents on the public highway, following a direct impact on the shoulder, through contact or a fall. Contact sports (rugby, judo, etc.) are particularly prone to this type of dislocation.
Symptoms: the patient usually notices pain and functional impotence, as well as ecchymosis, oedema and deformity of the shoulder, with the clavicle protruding under the skin, depending on the severity of the dislocation.
Shoulder tendonitis
Inflammation of a tendon.
Symptoms: pain and difficulty in performing movements that are usually basic and easy.
Throwing sportsman’s shoulder
This is a posterosuperior shoulder impingement. It explains most of the shoulder pain experienced by athletes performing throwing movements. While this contact between the deep surface of the cuff and the posterior edge of the glenoid is physiological, the repetitive nature of throwing movements is a predisposing factor to the lesions identified.
Treatment: cessation of sport will bring symptomatology to an end, arthroscopy.
Risk factors for shoulder pain
Certain professional activities are conducive to musculoskeletal disorders, and shoulder injuries in particular, as the joint is subject to heavy strain.
This is the case when :
- The work imposes postural constraints (work done with arms in the air or hands stretched out in front of the body or over the shoulder).
- Harmful gestures such as raising the arm are frequently repeated.
- Professional activities requiring significant muscular effort of the shoulder, even when carrying heavy loads infrequently.
Certain sporting activities involving the arm and throwing gestures (handball, volleyball, javelin, tennis…) or activities at risk of trauma (rugby, soccer, judo…) are responsible for lesions following microtrauma linked to overuse of the joint.
Advice
Adopting the right daily gestures
You can limit this by dressing the painful side first, so you don’t have to contort your sensitive arm. To undress, however, start with your valid shoulder and end with the one that’s causing you pain.
For a good night’s sleep, it’s best to lie on your back or opposite side. If necessary, place a pillow under your sore arm to avoid tension when you wake up.
Strengthening exercises
You can keep these aches at bay with regular stretching exercises:
- Sit with your back straight, facing a door held between your knees.
- Place a rubber band around the handles and hold the ends.
- Pull the elastic towards you, lowering your shoulders and squeezing your shoulder blades.
- Hold the position for 6 seconds, before slowly releasing.
- Repeat the exercise 10 times.
- Sitting on a chair with your back straight, wrap a rubber band or scarf around your wrists. Keeping your elbows close to your body, try to spread your forearms, fighting against the resistance of the tie.
- Hold the position for 6 seconds, then release.
- Repeat the exercise 10 times.
The benefits of osteopathic treatment for painful shoulders
In the case of tendonitis, the osteopath will focus on the shoulder and elbow joints. He will test and treat, if necessary, the cervical vertebrae to ensure not only optimal mobility to avoid further strain on the shoulder muscles (as well as the thoracic vertebrae and ribs), but also optimal innervation of the muscles by eliminating any nerve compression that may exist.
In the case of tendon rupture, the osteopath plays an important role in the post-operative phase, working on the fascia and arthroscopic scars to prevent adhesions from forming. The osteopath also has a role to play in restoring shoulder mobility, using techniques that complement physiotherapy, which is absolutely essential.
