shoulder pain Archives - Michigan Spine & Pain

Don’t Shoulder the Pain!

Our shoulders are truly amazing. Our arms have incredible range of motion, allowing us to create windmills, throw a ball overhand and underhand, bowl, golf, flip a pizza and carry our groceries.

But the price of all that versatility is that when our shoulders hurt, our everyday functioning is seriously impaired.

What we call our shoulder is actually the area where three bones join together in a complex network of bones, tendons and muscles. The three bones are the upper arm bone (the humerus), your collar bone (clavicle) and your shoulder blade (scapula). The rounded head of the humerus fits into the socket-shape of the scapula. The entire area where they meet up is typically referred to as the rotator cuff.

Shoulder problems are not uncommon, plaguing us more as we get older and also most bothersome for people who repeat the same motions over and over, particularly work-related activity or athletic pursuits.

The most common causes of shoulder pain are:

Arthritis
Fractures (broken bones)
Issues with the tendons like inflammation (bursitis or tendinitis) or tears in the tendon

When your shoulder pain impacts your functioning or causes chronic or acute pain, it’s time to see a doctor. The physician will determine the cause of the shoulder pain and then determine the best method to treat the shoulder pain.

Typical components of the diagnosis will be taking a complete medical history including discussing when the pain or immobility began and how much pain you are in. The doctor will examine you and probably order diagnostic exams including x-rays (to look at the skeletal underpinning) and/or MRI’s or ultrasounds and possibly a CT scan to detect issues in soft tissue. The doctor may also order an arthogram where dye is injected into the shoulder to better evaluate how the shoulder operates. Or the doctor may order arthoscopy, where a tiny camera looks into the shoulder joint area, allowing an incredible view and sometimes enabling a doctor to make repairs on the spot.

Depending on what actually is causing your shoulder pain, your health care team will present you with some possible courses of action to decrease your shoulder pain.

These can include:

Medication, both over the counter and prescription
Physical therapy to strengthen weakened muscles or modifications of certain movements
Chiropractic adjustments can aid in shoulder pain
Steroid injections can numb or reduce pain
Surgery in the most severe cases

Working with your health care team, you can work to resolve and improve shoulder pain.

Avoiding Overuse Injuries

Sometimes our body aches because of the presence of disease, like arthritis or fibromyalgia or various headaches, like migraines. Sometimes, we are in pain because of injuries to the bones or muscles.

There are several common injuries that are typically the result of overuse, either from athletic pursuits, work routines or regular daily life activities. Overuse kind of sneaks up on you. It may start off as a twinge that goes away and over time develops into more constant or consistent pain associated with specific activities.

Frequently occurring overuse injuries are:

Shin Splints (Leg pain which worsens with running or walking)
Tennis Elbow/Golfer’s Elbow (weakness and/or pain inside or outside the elbow)
Runner’s Knee (pain behind the kneecap, made worse with running, walking, jumping, cycling and ascending or descending steps)
Rotator cuff tendinitis (shoulder pain felt when lifting the arms straight up or in a circular motion like a swimming stroke)
Plantar Fascitis (usually felt in the feet and ankles upon first waking up)
Achilles Tendinitis (typically presents as ankle pain)

Overuse injuries are the result of too much exertion, combined with muscle weakness. The major ways to prevent the above injuries include babying yourself a little bit by not hitting the same muscles day after day. When you work out, be sure to warm up before true exertion. Most importantly, after exercising or after a long period of working, take time to stretch and cool down. Be sure you are moving appropriately. Contact a coach or trainer to check your form or consult with a physical therapist to demonstrate what hurts and learn compensating exercising to increase strength, flexibility and reduce pain.

If you are trying to increase exertion or activity, do so gradually, not all in one spurt of activity. If you’ve led a sedentary life, you can’t go from sitting on the couch to running a marathon. Start by adding 15 minutes of exertion and add a maximum of 10 minutes per day.

Being more active is a great goal. Being safe and avoiding overuse injuries should also be a concurrent objective.

Functional fitness: Is it right for you?

If you suffer from pain, you have likely received advice about the therapeutic aspects of exercise. Exercise is good for your body and your mind. Exercise can help with weight control, increases flexibility and range of motion, can be an antidote to stiff joints and also has positive psychological components.

But what kind of exercise program should you embark on? There are so many exercise options out there. You can join a gym, enroll in classes, walk or run on your own or with a buddy. Weight-bearing exercises, cardio exercises, circuits, Pilates, yoga, high intensity, low impact…the list is dizzying.

Your physical therapist will surely encourage you to be consistent in exercising almost daily. Many physical therapists are also recommending that their pain patients aim for functional fitness.

Functional fitness exercises train your muscles to help you do everyday activities safely and efficiently. Functional fitness exercises work to train various muscle groups to work in tandem with one another. This helps to prepare you to perform the tasks you encounter at home and at work.

Instead of rowing at a machine, think about doing the rowing motion with hand-held weights while you are actually bent over at the waist or while standing up with your arms rowing parallel to the ground. This mimics lots of everyday motions: taking groceries out of the back of the car, lifting a child out of a car seat, or even doing various manufacturing jobs. This, then, is the epitome of functional fitness: a fitness routine that strengthens various muscle groups (in this case, arms, back, neck and shoulder muscles as well as strengthening your core) so that you can be “functionally fit” to do those desired everyday tasks.

Physical therapists as well as trained exercise consultants can help you develop a group of functional fitness exercises, based upon what you need to get through your day physically. Perhaps you are a caregiver for a loved one. Often, the tasks associated with caregiving (turning a person over, helping them transfer from lying to sitting to standing and back again) require a different type of fitness than just doing bicep curls at the gym. Other typical functional fitness exercises include squats (with both feet planted and with one leg planted), squats with an overhead press, lunges and what are called dead lifts.

As with all exercise routines, functional fitness should only be undertaken under the advice and consent of your physician.

Understanding Shoulder Pain

Shoulder pain can be at a minimum distracting and at its worst, disabling. But shoulder pain can be somewhat tricky to diagnose. Shoulder pain can be caused by inflammation or injuries to any of these components: the shoulder joint (involving the clavicle, scapula and humerus bones), the tendons, the surrounded ligaments, or a rotator cuff injury. In addition, shoulder pain can be caused by bursitis or arthritis, in addition to disease processes that affect bones and muscles.

To properly diagnose shoulder pain, a physician will examine and interview the patient, will gently touch around the area (called palpation) to try to determine what improves or exacerbates the pain and will often order x-rays. While interviewing the patient, the doctor will ask the following questions:

Do you remember a specific injury occurring?
Do you have any sort of history of shoulder pain or previous injuries?
How much pain are you in now?
How long have you been in pain?
How is your shoulder or arm movement affected? (Do you have trouble lifting, cooking, etc.?)
What is your exercise regimen and how is your shoulder pain affected? (Golf, tennis, swimming and baseball/softball are often repetitive motion sports that can cause shoulder ailments.)
Do you have any weakness?
Do you have stiffness?
How is your flexibility?
What treatments have you already tried?
Do you notice anything that improves or worsens your pain level?

After this interview and ordering tests, doctors begin to narrow in on the cause of the shoulder injury in order to determine how to proceed with treatment. They will first exclude joint involvement, then determine the state of the rotator cuff (typically by ordering either MRI or ultrasound tests) and also try to figure out if “frozen shoulder” is present.

Eventual treatment can include splinting and immobilizing, physical therapy, chiropractic treatment, medication or in the most severe cases, surgery.

1-800-586-7992

Don’t Shoulder the Pain!

Avoiding Overuse Injuries

Functional fitness: Is it right for you?

Understanding Shoulder Pain

Real Relief

Real Solutions

Locations

Our Sister Company