Shoulder pain is a right pain. Suddenly everyday things become an effort. Washing your hair, putting a coat on or reaching for anything can bring on searing pain. But how do you know if it’s serious?
We have put together a quick self-assessment you can take right now.
The shoulder is a complex system of joints that when working together enable a large range of motion for pushing, pulling lifting and throwing.
There are three key bones forming the shoulder which sit on the rib cage: as shown below.
The combined action of these joints allowing such mobility does however come at a cost to stability. It is important to understand that shoulder stability is a combined function of passive and active work carried out by an orchestra of tissues. The image below gives a birdseye view of the shoulder socket with passive structures (ligaments) in place.
Do not get too concerned with the long complicated names but be aware that any name followed by ‘ligament’ comprises our ‘passive’ support and any name ending in ‘tendon’ describes our active, or muscular support. The rest of the shoulder stability comes from muscles. Most importantly these muscles must fire at the right time. When they don’t bad things happen. This can be a slow process but once it has progressed enough can give rise to impingement syndrome.
This series of events is collectively termed impingement syndrome. There is a simple for this.
A positive test is one that produces pain or inability to raise the elbow and we consider this a RED FLAG. A red flag means you should not persevere with any training or workplace activity that aggravates your shoulder and get managed by a trained clinician.
When you have an impingement syndrome there is active inflammation present in the shoulder that is working tirelessly to kick start the healing process.
Active recovery is the answer (ARITA) and is essential to facilitate this process as oppose to ICE and IMMOBILISATION; examples of which can be found below.
Another early manifestation of this could be reduced rotational capacity at the shoulder and can be tested by yourself. If this test is positive then we call it a yellow flag, meaning that it is not yet clinically a problem but some focused mobility / muscle activation is indicated:
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