Shoulder anatomy 101<\/h2>\n\n\n\n

BONES: The shoulder complex is made up of 4 main bones, your humerus, scapula, clavicle and sternum. These combine to make 4 joints that all affect how your arm moves. <\/p>\n\n\n\n

LIGAMENTS: The ligaments in the shoulder are small, this allows us increased\nmobility but sacrifices stability. <\/p>\n\n\n\n

MUSCLES: This infamous structure is a collection of 4 muscles: subscapularis, infraspinatus, supraspinatus and teres minor. Good names huh? That\u2019s why we call it the rotator cuff\u2026 These muscles are located on the back of your shoulder, with your pectoralis major and deltoid supporting the front. <\/p>\n\n\n\n

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Rotator cuff tear<\/h2>\n\n\n\n

What it is – The four muscles that make up the rotator cuff are responsible for keeping the \u2018ball in the socket\u2019 and assists in moving your arm. The leading cause of shoulder pain and disability, rotator cuff tears are common in sportspeople and those who do a lot of overhead work. They can be from traumatic injuries or from micro-tears that build up over time and lead to degenerative changes. <\/p>\n\n\n\n

What it feels like – pain at night, with overhead activities, weakness and stiffness in the shoulder. Difficulty raising your arm, compensating by hiking through your upper traps in your shoulder. Pain can also radiate down the arm and into the neck. <\/p>\n\n\n\n

Treatment<\/h3>\n\n\n\n

Manual therapy – works on muscle tension that may be affecting the position and mobility  of the shoulder blade and humerus causing increased pain at the area. Exercises to strengthen the un-injured muscles and increase stability. Once the injured tendon has healed, focus is put on regaining the ability to activate and strengthen that muscle. <\/p>\n\n\n\n

Medical – surgery to reattach the tendon, for complete or large partial tearsonly. This requires a referral to a specialist which your osteopath can organise. Receiving medical treatment before surgery is always a good option to improve your surgery outcomes. Surgery will also depend on how much you use your shoulder in work and sports. Over time your body can compensate even if a muscle or tendon has completely ruptured.<\/p>\n\n\n\n

Other \u2013 ice\/heat, rest, time. <\/p>\n\n\n\n

Rotator cuff tendinopathy:<\/h2>\n\n\n\n

What it is \u2013 every muscle is connected to bone via a tendon. Tendinopathy occurs\nwhen there is a period of overuse, or increased compression or load. The tendon\nthat is placed under strain fails to fully heal and the result is a swollen and\nvulnerable structure. <\/p>\n\n\n\n

What it feels like – Dull pain that increases over time. Sometimes sharp pain\/pinch in the shoulder or lifting your arm overhead. Growing weakness and pain with arm movement\/sleeping on it. <\/p>\n\n\n\n

Treatment <\/h3>\n\n\n\n

Manual therapy: Massage to reduce swelling and improve function in the muscle. Injury specific exercises. Advice on asymmetries in training\/movement. Strengthening work to ensure other muscles around your shoulder are strong and supportive.<\/p>\n\n\n\n

Medical: corticosteroid injections (often doesn\u2019t last for more than a month). If you do opt for this try and get a guided injection to ensure the right spot is targeted.<\/p>\n\n\n\n

Other: anti-inflammatories such as ibuprofen. Ice to reduce swelling. Rest from aggravating activities.<\/p>\n\n\n\n

Shoulder impingement<\/h2>\n\n\n\n

What it is \u2013 There is a small space (approx. 1cm)   underneath your clavicle and scapula called the acromioclavicular joint (see above). In the space runs the tendon to one of the rotator cuff muscles \u2013 Supraspinatus. Along with this tendon is a pad called a bursa, which helps the tendon to glide back and forth smoothly. If either of these get irritated (such as tendinopathy or bursitis) and swell up, the tissues get compressed into the small space and cause pain. <\/p>\n\n\n\n

What it feels like\n– pain in the front of side of the shoulder that\nincreases when the arm is lifted. Increased tension in the neck and increased\nheadache frequency. <\/p>\n\n\n\n

Treatment <\/h3>\n\n\n\n

Manual therapy: Conservative treatment of this injury can take up to a year in some cases however a decrease in symptoms is often noticed much sooner. It involves reducing tension in the shoulder\/back\/neck to encourage optimal function of the muscles and function of the joints. Guided rehabilitation and techniques to increase the space are also provided as well as improving overall strength.<\/p>\n\n\n\n

Medical: corticosteroid injection but only once manual therapy options have been exhausted. <\/p>\n\n\n\n

Other: rest from overhead activities, shockwave or laser therapy. <\/p>\n\n\n\n

Dislocation\/instability<\/h2>\n\n\n\n

What it is \u2013 Considering the anatomy explained above, with the lack of ligament and muscle support in the front of the shoulder, it\u2019s no wonder that shoulders frequently dislocated forward (97% of all dislocations). This often occurs when the arm is stretched up in a reaching position. Instability occurs after a dislocation is the surrounding supporting structures have been stretched or torn, allowing the ball joint to \u2018pop out\u2019 easily. Nerve and rotator cuff damage can also occur. <\/p>\n\n\n\n

What it feels like – If dislocated all movements are painful and the top of the humerus look misplaced. You'll be very limited with your range until the shoulder is relocated. Often people experience dislocations that spontaneously relocate by themselves. This instability can cause the shoulder to ache, feel loose, or vulnerable in positions such as reaching up or reaching up and back.<\/p>\n\n\n\n

Treatment<\/h3>\n\n\n\n

Manual therapy: to help ease any muscular spasms and tension that has developed due to pain in the shoulder. This sets you up well for rehab.<\/p>\n\n\n\n

Medical: relocation of joint, surgery to restore stretched\/torn structures. Surgery can generally wait until the shoulder has been assessed.<\/p>\n\n\n\n

Immobilisation: 3-6 weeks if under the age\nof 40 and 1-2 weeks if over the age of 40. <\/p>\n\n\n\n

Restore motion: Work on slowly restoring full range of motion in the shoulder with specific functional exercises.<\/p>\n\n\n\n

Strengthening: exercises introduced to\nprepare the muscles for a full return to sport\/work. <\/p>\n\n\n\n

The importance of rehab<\/h2>\n\n\n\n

As you can see, these injuries often have a\nlong rehab process that requires a combined effort from patient and their\nmanual therapist, with specific exercises and treatments. The amount of effort\nyou put into your rehab, whether it be resting (actually resting) or doing the\nexercises prescribed, the faster you will be pain free. <\/p>\n\n\n\n

If you have a sore shoulder that\u2019s just not\ngoing away, book in with one of our practitioners today for an assessment. We\nare here to help! <\/p>\n","protected":false},"excerpt":{"rendered":"

Wanaka and Queenstown could very well be the town with the most shoulder injuries in NZ. Here at Metamed we frequently see patients that have hurt their shoulder while partaking in one of the many outdoor activities that many people in this area enjoy. Mountain-biking, skiing, parasailing, you name it. The shoulder is a complex […]<\/p>\n","protected":false},"author":4,"featured_media":3952,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","ub_ctt_via":"","_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":""},"categories":[93,3,193],"tags":[],"author_meta":{"display_name":"Anna Burgess","author_link":"https:\/\/metamed.co.nz\/author\/anna\/"},"featured_img":"https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-300x200.jpg","featured_image_src":"https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain.jpg","author_info":{"display_name":"Anna Burgess","author_link":"https:\/\/metamed.co.nz\/author\/anna\/"},"uagb_featured_image_src":{"full":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain.jpg",1000,667,false],"thumbnail":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-150x150.jpg",150,150,true],"medium":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-300x200.jpg",300,200,true],"medium_large":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-768x512.jpg",768,512,true],"large":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain.jpg",1000,667,false],"1536x1536":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain.jpg",1000,667,false],"2048x2048":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain.jpg",1000,667,false],"featured-75":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-75x75.jpg",75,75,true],"featured-150":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-150x150.jpg",150,150,true],"img-1-column":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-695x365.jpg",695,365,true],"img-2-columns":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-528x285.jpg",528,285,true],"img-3-columns":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-345x185.jpg",345,185,true],"img-4-columns":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-252x145.jpg",252,145,true],"box-slider":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-1000x550.jpg",1000,550,true],"full-width":["https:\/\/metamed.co.nz\/wp-content\/uploads\/2020\/01\/Man-with-shoulder-pain-1000x550.jpg",1000,550,true]},"uagb_author_info":{"display_name":"Anna Burgess","author_link":"https:\/\/metamed.co.nz\/author\/anna\/"},"uagb_comment_info":0,"uagb_excerpt":"Wanaka and Queenstown could very well be the town with the most shoulder injuries in NZ. Here at Metamed we frequently see patients that have hurt their shoulder while partaking in one of the many outdoor activities that many people in this area enjoy. Mountain-biking, skiing, parasailing, you name it. The shoulder is a complex…","yoast_head":"\n