The shoulder joint is classified as a ball & socket joint which involves the top of the humerus bone articulating within the glenoid cavity that is supported by muscles, ligament, tendons and other soft tissues. Numerous problems may exist around the shoulder joint which need to be diagnosed correctly by a skilled clinician to ensure the most effective treatment and management is conducted.
Common Conditions: ‘Shoulder Bursitis’ is an inflammation of the bursae (fluid-filled sacs). The ‘sub-acromial bursa’ acts like a “cushion” between the bones and the surrounding muscles in the shoulder joint. A ‘Frozen Shoulder’ is a mild to severe inflammation of the soft tissue including the joint capsule within and around the joint. Both conditions can often be linked to sports that put repetitive strain on the shoulder such as tennis and swimming. Frozen shoulders may also develop due to trauma and chronic degeneration of the joint and rotator cuff muscles. ‘Impingement syndrome’ is a related condition that is common in sports involving overhead movements such as bowling in cricket or serving in tennis. Other repetitive and sustained overhead activities such as DIY activities can also contribute to the impingement. The impingement normally attributes to chronic rotator cuff irritation and resultant inflammation leading to thickening and swelling of the tendons which “impinges” the joint within the sub-acromial arch. Poor posture may also be a causative factor.
Symptoms & Diagnosis: Shoulder bursitis normally presents itself with soreness when you perform overhead movements or put weight on the affected shoulder. Symptoms vary from mild to severe pain, range of movement restriction, loss of arm strength and swelling on the lateral aspect of the arm. Frozen shoulders normally accompany pain which deteriorates at night or when you try to lift the arm. Symptoms of impingement syndrome may include shoulder pain, difficulty raising the arm, pain when reaching behind your back and a grinding sensation when you move the shoulder. X-rays and MRI scans may be warranted to investigate the problem further.
Risks & Complications: If left untreated, bursitis may lead to further inflammation and the potential infection of the fluid in the bursae which may necessitate the need for surgery. Chronic impingement syndrome may develop and cause a stiff and immobile shoulder with the added risk of a rotator cuff tear. Frozen shoulders may require manipulative surgery if the lack of mobility, pain and loss of function progress resulting in a build up of scar tissue around the joint.
Management: Physiotherapy will help to ease shoulder pain and the associated inflammation of all conditions. Manual therapy and strengthening may be recommended at the correct stage to help with the required rehabilitation. Onward referral maybe necessary for further investigations in conjunction with a local injection.
Please feel free to contact the G4 Clinic to speak to a member of the team for any questions that you may have.