Shoulder
Shoulder conditions are commonly associated with pain and restricted range of motion, significantly impacting daily activities and athletic performance. Accurate diagnosis and targeted, evidence-based rehabilitation are essential for achieving optimal recovery and a safe return to activity.
Rotator cuff injuries
The rotator cuff is a group of muscles and tendons that surround the shoulder joint, helping to stabilize the humeral head within the joint. An injury to the rotator cuff can cause persistent shoulder pain, often worse at night.
Rotator cuff injuries are common and become more prevalent with age. They may occur earlier in individuals whose work involves repetitive overhead movements, such as throwing athletes, basketball players, and manual workers.
Most rotator cuff injuries result from the gradual degeneration of the tendons over time. Repetitive overhead activities or prolonged lifting of heavy objects can strain or damage the tendons. In addition, a rotator cuff injury can occur suddenly due to falls or trauma.
Symptoms of a rotator cuff injury may include:
• A deep, dull pain in the shoulder
• Sleep disorders
• Difficulty reaching behind the back or combing one's hair
• Weakness in the hand
In some cases, a rotator cuff injury may not cause pain.
Physical therapy and targeted therapeutic exercises can help reduce pain and swelling, while also improving flexibility and strengthening the muscles around the shoulder joint.
Shoulder dislocation
A shoulder dislocation occurs when the humeral head is displaced from the glenoid fossa of the scapula. The shoulder is the most mobile joint in the body, which makes it more vulnerable to dislocations.
If you suspect a shoulder dislocation, seek immediate medical attention. Most individuals regain full range of motion within a few weeks; however, following a dislocation, the shoulder may be more prone to recurrent instability or future dislocations
Symptoms of shoulder dislocation include:
• Visible distortion
• Swelling
• Severe pain
• Inability to move the joint
A shoulder dislocation can also cause numbness, weakness, or tingling in the affected area, such as in the neck or along the arm. Muscle spasms around the shoulder can also intensify the pain.
Common causes of a shoulder dislocation include:
• Sports injuries: Shoulder dislocations are common in contact sports such as football and hockey, as well as in sports that involve falls, such as skiing, gymnastics, and volleyball.
• Non-sports-related injuries: A strong impact, such as a motor vehicle collision.
• Falls: Awkward landings, such as from a ladder or falling onto an uneven surface, can cause a shoulder dislocation.
If ligaments, tendons, or nerves are severely damaged after a shoulder dislocation, surgical repair may be required.
Physical therapy and therapeutic exercise relieve pain symptoms and inflammation, strengthen the muscles around the joint, and help not only treat the injury but also prevent future flare-ups.
Frozen shoulder
Frozen shoulder, also known as adhesive bursitis, is characterized by stiffness and pain in the shoulder joint. Symptoms usually begin gradually and worsen over time, but tend to improve within 1 to 3 years.
Immobilizing the shoulder for a long period of time increases the risk of developing frozen shoulder, often after surgery or a fracture to the arm.
Treatment includes physical therapy, range of motion exercises, and therapeutic exercise. In rare cases, arthroscopic surgery may be required to loosen the bursa and improve mobility.
Symptoms
Frozen shoulder usually progresses in three stages:
• Cooling stage: Any movement of the shoulder causes pain and the range of motion is limited. This stage lasts from 2 to 9 months.
• Freezing stage: The pain may decrease, but the shoulder becomes stiffer, making it difficult to use. This stage lasts from 4 to 12 months.
• Defrosting stage: The range of motion of the shoulder begins to improve. This stage can last from 5 to 24 months.
For some people, the pain may intensify during the night, affecting sleep.
It is rare for frozen shoulder to recur in the same shoulder. However, some people may develop it in the other shoulder, usually within five years.
Acromioclavicular joint injuries
The acromioclavicular (AC) joint is located in the shoulder and plays a critical role in maintaining stability, movement, and strength of the shoulder. It is supported by a bursa and ligaments, which, when damaged, can lead to instability, pain, and reduced function of the shoulder. This type of injury is known as an acromioclavicular joint «sprain» or «injury» and usually results from a sudden fall onto the shoulder. In addition, the acromioclavicular joint is a common site of arthritis, which can cause pain due to gradual wear and tear over time. This degenerative condition is especially common in weightlifters and manual workers.
Symptoms of injury or arthritis of the acromioclavicular joint:
• Pain at the top of the shoulder, above the acromioclavicular joint
• Visible protrusion
• Edema (swelling)
• Shoulder stiffness and reduced range of motion
• Pain when raising the arm to the side or in front of the body
Causes of acromioclavicular joint injury:
• Falling on the shoulder
• Lifting heavy objects or lifting weights
In contrast, arthritis of the acromioclavicular joint develops gradually due to repetitive use and long-term strain on the joint.