The shoulder is an inherently unstable joint. This is due to the shallow socket and the minimal joint surface contact of the bones. This is what allows for the large range of movement of the shoulder. The shoulder obtains its stability from the muscles and ligaments which surround it. Injury to the shoulder is often caused by a dysfunction in coordination between the mobilising and stabilising muscles of the shoulder or weakness of the shoulder muscles.
In order for a person to obtain full range of shoulder movement, movement has to occur at both the shoulder joint and the shoulder blade. This movement is referred to as the scapulohumeral rhythm.
The muscles responsible for keeping the arm (humerus) against the shoulder blade (scapula) are referred to as the rotator cuff muscles. As the name suggests these muscles form a protective cuff around the shoulder joint. These muscles form tendons which run through a bony arch in the shoulder.
Rotator cuff Syndrome
This is a broad name given to injuries related to the rotator cuff muscles.
Specific injuries include:
- Rotator cuff impingement
- Rotator cuff tendonitis
- Shoulder bursitis
- Rotator cuff tears
- Calcific tendonitis
- Pain with overhead movements.
- A painful arc of movement.
- Pain with throwing.
- Pain when reaching behind your back or over your opposite shoulder.
- Pain when lying on the shoulder.
- Weakness in the shoulder.
The space through which the muscles and tendons run in the shoulder can sometimes become narrowed as a result of muscle weakness and poor coordination of the scapulo-humeral rhythm. The narrowing of this space may then result in impingement of the rotator cuff muscles and inflammation of the tendons or bursa.
- Physiotherapy treatment is aimed at correcting the bio-mechanics to the shoulder and scapula.
- Mobilising techniques are used to regain full shoulder movement as well as to reduce pain and inflammation.
- Myofascial release is applied to muscles that may be tight and restricting movement.
- Taping may be used to give additional support to the shoulder while healing is taking place.
- Electrotherapy modalities may be used to reduce pain and inflammation.
- Specific exercises will be prescribed to strengthen the rotator cuff muscles and the stabilising muscles of the scapula.