ADVERTORIAL
SHOULDER PAIN :
Causes , Prevention & Treatment
THE SHOULDER IS ONE OF THE MOST AMAZING JOINTS OF THE BODY . IT ' S NOT A SINGLE JOINT BUT A COMPLEX OF 5 JOINTS ALLOWING A 360 DEGREE ARC OF MOVEMENT . THE SHOULDER CAN ASSUME OVER 1000 POSITIONS MAKING IT VULNERABLE TO OVERUSE AND INJURY .
BY PROF . BIJAYENDRA SINGH , ORTHOPAEDIC SURGEON
Shoulder pain is a common condition affecting the workplace – it accounts for around 1,420 sick days per 10,000 workers , resulting in an estimated 8.9 million lost working days . In 2019 / 20 , 30 % of all work-related ill health was due to musculoskeletal disorders , of which 44 % were upper limb or neck related .
What are the causes of shoulder pain ?
This can be classed into two broad groups – one arising from direct shoulder pain and the other , referred pain . Referred pain can be from the neck or back , or caused by chest or abdominal problems . Referred pain does not generally get worse on movement of the shoulder .
What are the common causes of a painful shoulder ?
The common causes include rotator cuff ‘ tendinopathy ’ which is often labelled as ‘ impingement ’, ‘ tendinitis ’, ‘ bursitis ’ or ‘ inflammation ’. This can affect any age , although it is more common after the age of 40 .
The other causes of shoulder pain include frozen shoulder , arthritis , rotator cuff tear , biceps problems , calcium deposition in rotator cuff tendons , and of course various fractures around the shoulder .
What brings on the shoulder pain ?
Chronic shoulder injury is a common problem for people of all generations . Among the population at large , day to day activities , DIY or gardening can lead to pain as well as resistance exercises in the gym . Any overhead activity which involves positioning the hand away from the body can cause damage to the rotator cuff .
PREVENTION :
General Strengthening : This should involve the ‘ outer core ’ for the rest of the body , as if this is out of sync it may lead to loading the shoulder . Whilst training , athletes often forget the muscles at the back especially the lower trapezius , rhomboids , posterior deltoid , and posterior cuff – these may cause pain and are an essential part of balanced strengthening exercises .
Rotator Cuff : These are dependent on good positioning of the shoulder blade for effective control , poor positioning may lead to injury to the cuff .
Sports Specific : These are covered under the term ‘ plyometrics ’ and require the athlete to undergo rehabilitation according to their requirement , for example it will be different for a thrower or tennis player compared to a rugby player .
Warm Up : Do not exercise your muscles ‘ cold ’. Do an adequate warm up before putting any stress on the shoulder muscles .
Regular Breaks : Take a break at regular intervals if frequent overhead work out is required . Avoid , or at least reduce repetitive overhead movements if possible .
WHAT CAN I DO MYSELF ?
Rest : A period of rest from any activity which causes pain is vital to avoid further injury and pain . This does not mean complete immobility of the shoulder , but avoid loading exercises and keep the shoulder mobile .
Change your sleeping position : If this is a problem , try using a pillow to rest the arm when lying on your back , or put a pillow between your arm and body if lying on the side .
Increase your shoulder strength : Build up shoulder strength gradually using lower weights and more repetitions , before moving to higher weights and lower repetitions .
RICE : Rest , ice and simple painkillers like paracetamol and ibuprofen ( if not allergic ) can alleviate discomfort .
If these measures fail , seek an expert opinion . Unfortunately I see a number of patients who have had a number of investigations but not the correct diagnosis and hence have not received the correct treatment .
Prof . Bijayendra Singh is a consultant orthopaedic surgeon practising at Spire Alexandra Hospital and KIMS Hospital in Kent . For further information or to book an appointment with Prof . Singh visit www . kentorthopaedicpractice . co . uk .
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