Shoulder problems

Hello this is Neil and Nic from Plym Physio and today we are going to talk about shoulder problems, or problems that masquerade as shoulder problems.

The shoulder and hip have some similarities but are functionally very different.  The hip has a deep ball and socket joint and favours strength over mobility whilst the shoulder has a shallow ball and socket joint and requires mobility over strength.  The ball and socket of the shoulder is more akin to a golf ball sitting on a tee, inherently unstable, it needs support from muscles and the joint capsule to maintain any stability.

So again before you click off, when is a shoulder problem not a shoulder problem – when it’s a neck problem of course.  A large percentage of shoulder problems are referred from the neck, even when patients are absolutely certain that it is the shoulder but that is not really what we are looking at today.

Most people that have survived adolescence will have experienced some shoulder pain, as already mentioned it needs to be a highly mobile joint which also makes it a little fragile.  Often this pain is described as having slept funny and goes away on its own.  If shoulder pain does not heal on its own it can quickly become limiting.  Many people do not realise they are becoming limited and just live within the boundaries their own bodies have created.  Then when they are required to move outside of these limits they discover how painful the shoulder can be.  Functional tasks such as reaching into cupboards or brushing hair can be very painful.

The shoulder comprises four joints and they are all different types:

The ball and socket joining the humerus to the scapular (shoulder blade), this is what everyone classically thinks of as the shoulder.

The sliding acromioclavicular joint which joins the collar bone to the shoulder blade.  It is very familiar to many rugby players, motorcyclists and skiers as it is prone to impact injuries

The sternoclavicular saddle joint which joins the other end of the collar bone to the sternum, yes that’s a joint and yes it moves.  Just put your finger on it and move your arm; this is what holds your arm onto the rest of your skeleton.

The scapulothoracic joint which is a pseudo joint between the shoulder blade and the rib cage.  It glides and moves way more than most people realise.

Why this matters is because if one of the joints becomes dysfunctional (slept on it funny kind of pain), the others try to take up the slack and compensate, this can be effective at first and allows the problem to grow.  The first sign of pain is often one of the other joints grumbling.  If ignored at this stage the problem may seem to come and go but will generally be getting worse.

Two really easy things to help your shoulders are posture and breathing.  Bearing in mind how vital to survival breathing is, many of us are quite poor at it.  It is very difficult to maintain poor posture if you fully inflate your lungs so the two are intertwined.  Modern life puts everything in a box in front, of us so we end up letting our head flex forward as well as our shoulders.  This puts an excessive curve in our upper spine which makes it difficult for the shoulder blades to glide over the ribcage.  This compromises one of the joints so the others become affected.

So very simply, stand as tall as you can, pull your shoulders back and down so you have a neck and breath deeply – importantly do this before you have a problem and then don’t develop one.  An ounce of prevention is worth a pound of cure.

If you cant stand up straight with your arms straight overhead, you might be developing a shoulder problem.

If you are already in the hurt locker, book in and come and see us.

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