Shoulder Pain and Dysfunction
Shoulder Pain: If there’s anything certain in exercise & rehabilitation, it is that the shoulder can be an extremely challenging area. What we usually think of as “the shoulder” is properly referred to as the “glenohumeral joint” (GHJ) – the connection between our scapula (shoulder blade) & humerus. There are multiple muscles which help to actively control the GHJ, alongside passive restraints such as the surrounding ligaments. Above the GHJ sits the “acromioclavicular joint” (ACJ). Then the clavicle (collarbone) connects to the sternum with the “sternoclavicular joint” (SCJ). Additionally, the scapula is connected via multiple muscles to your back, along the back of the rib cage, via the “scapulothoracic joint” (there’s no standard abbreviation for this joint unfortunately). This collection of interplaying joints, muscles, ligaments, and bones is so complex, we literally call it “the shoulder complex”. For each task we perform with our shoulders – whether it is reaching out to grab a tool, throw a ball or scratch our backs – there is a well-rehearsed and orchestrated chain of sequential muscle activation and joint angles which needs to occur for optimal performance. Complex, right!
When one element of this shoulder complex is not performing up to scratch, it can cause a chain reaction to the rest of the joints and muscles leading to overall dysfunction. For example, when one muscle is “weaker” it can cause other muscles to over-compensate and become dominant and fatigued, causing pain and stiffness. Because of the close proximity of the shoulder complex to the spine, disruptions in the shoulder can often spill over into its neighbour and cause neck or back aches and pains as well. We also have to remember that shoulder pain may be a referred pain from another source, such as the neck!
As you can see, the shoulder is super complex and there may be a variety of reasons as to why your symptoms may be present. If you’re experiencing difficulties with your shoulder movement, and you’d like expert advice to help you unravel the shoulder complex, a physiotherapist is your person to call.