The complexities of the shoulder joint present many opportunities for pain-causing conditions. Some of the most common causes of shoulder pain include:
Impingement. Impingement typically occurs because of abnormal movement and tracking of the humeral head as you lift your arm overhead. Pain typically starts when lifting your arm at or above 90 degrees.
Arthritis. The two main forms of arthritis that affect the shoulder are osteoarthritis and rheumatoid arthritis. Osteoarthritis occurs when the cartilage in the shoulder joint experiences significant “wear and tear,” typically due to age or excessive overuse. Rheumatoid arthritis occurs when the immune system decides to attack the membranes surrounding the shoulder joint, resulting in pain and inflammation. Both of these result in pain, loss of motion, weakness to the shoulder muscles, and difficulty performing normal, daily tasks.
Tendinitis. Tendinitis occurs when the shoulder joint is excessively overused typically due to the demands of a laborious job, overhead activity, or sport. Furthermore, poor posture is a major contributor, as this alters the normal forces on the tendons, and can set you up for tendon injury. This causes the tendons to undergo ongoing inflammation, resulting in swelling and painful impingement when raising your arm.
Frozen shoulder. Also known as “adhesive capsulitis,” frozen shoulder can occur if your arm has been in a cast or sling for a while, or if you have been bedridden for an extended period of time. It results in a painful loss of motion in the shoulder with a tightening of the shoulder joint that severely limits motion. There are some ethnicities that are more predisposed, and women tend to have more instances than men. Frozen shoulder is more common in women in the 40-60 years of age.
Rotator cuff tear. The rotator cuff is comprised of 4 muscles, tendons, and soft tissue that surround the shoulder joint. The job of the rotator cuff is to correctly guide the movement of the shoulder joint. With injury, overuse, poor posture, or even age, the rotator cuff can be partially or completely torn. Depending on the severity and situation, sometimes surgery is needed, but often the correct physical therapy treatments can help reduce pain and restore strength to the rotator cuff to compensate for the partial tear. If surgery is needed, physical therapy is an integral part of the pre and post-surgical rehabilitation for a full recovery.