| This is a very common problem that is seen daily | | | | in the muscle. The most common site of a tear is |
| in chiropractic practices. I have patients who come | | | | in the supraspinatus tendon. Severe injuries can |
| in to my offices and complain about their painful | | | | cause several of the tendons and muscles to tear. |
| and stiff shoulder. By this they usually mean that | | | | There are special movement tests that your |
| their upper trapezius muscles are tight and painful | | | | doctor can use to help determine which of the |
| and that they have restricted movement and pain | | | | muscles or tendons has been torn. |
| in the region of the upper thoracic spine where it | | | | Frozen Shoulder is another painful condition. Frozen |
| meets the cervical spine at the neck. | | | | shoulder, also known as adhesive capsulitis, is |
| Chiropractors enjoy a large success rate with | | | | characterised by progressive pain and stiffness in |
| these patients who respond well to manipulation | | | | the shoulder. The pain is felt deep in the shoulder |
| and muscle stretching. The second category of | | | | joint and may be worse at night. It can be |
| patients are those who have a genuine problem | | | | treated by cortisone injections or by a |
| with the shoulder. By this I mean the area where | | | | hydrodilatation, a surgical procedure developed by |
| the head of the humerus or upper arm bone | | | | Dr. Frank Burke of Melbourne. This procedure |
| inserts into the glenoid fossa of the scapula or | | | | involves an injection of saline and local anesthetic |
| shoulder blade. | | | | into the shoulder capsule. It is usually not overly |
| The muscles that hold the humerus in place are | | | | painful and is done at his practice in Prahran, |
| called rotator cuff muscles and there are four of | | | | Melbourne. This procedure has been very |
| those. Painful shoulder conditions that limit | | | | successful in a great majority of patients. The old |
| movement are common, and are caused by | | | | idea that one had to endure pain for 2 years has |
| problems with the shoulder joint and its | | | | been largely disbanded. |
| surrounding structures. The shoulder is more | | | | Dislocation of the shoulder can occur after a fall. |
| prone to injuries than other joints because of its | | | | Shoulder dislocation occurs when the ball-shaped |
| wide range of movement | | | | head of your upper arm bone (humerus) comes |
| What are some of the common causes of | | | | out of the shoulder socket. It may be caused by |
| shoulder pain? There are several conditions that | | | | a fall, a sporting injury, or trauma, and is an |
| cause pain and limit movement of the shoulder | | | | extremely painful condition. A dislocated shoulder |
| joint, including: | | | | is visibly deformed or out of place, and there |
| * Rotator cuff disorders. The rotator cuff is a | | | | may be swelling or bruising around the joint. |
| group of muscles and tendons that help to move | | | | Shoulder movement is severely restricted in |
| the shoulder and hold the joint in place. Rotator | | | | people with a dislocated shoulder. Doctors can |
| cuff disorders result frominflammation or damage | | | | usually put the shoulder bones back into place |
| to the rotator cuff muscles or tendons, or | | | | using gentle manoeuvres. |
| inflammation of the subacromial bursa (which is a | | | | Following a dislocation, the shoulder joint |
| fluid-filled pad that sits under the highest part of | | | | sometimes becomes unstable and is susceptible to |
| the shoulder). The inflammation can be caused by | | | | repeated dislocations. This condition is known as |
| general wear and tear that occurs with age, | | | | shoulder instability, and causes pain and |
| activities that require constant or repetitive | | | | unsteadiness when you raise your arm or move it |
| shoulder motion (especially aboveshoulder level), | | | | away from your body. Your shoulder may feel as |
| heavy lifting, trauma, or poor posture. Serious | | | | if it is slipping out of place when you lift your arm |
| injuries and untreated inflammation of the tendons | | | | over your head. |
| can cause the rotator cuff to tear. | | | | |
| The pain associated with rotator cuff problems is | | | | Arthritis can cause shoulder pain. Arthritis causes |
| normally felt at the front or on the outside of the | | | | progressive joint pain, tenderness, swelling and |
| shoulder, particularly when you raise your arm or | | | | stiffness. Both rheumatoid arthritis and |
| lift something above your head. You may also | | | | osteoarthritis can affect theshoulder |
| notice the pain more when lying in bed. Severe | | | | joint. Shoulder pain can come from other causes |
| injuries can cause weakness of the shoulder | | | | such as referred pain. Sometimes shoulder pain is |
| muscles, restricted shoulder movement and | | | | actually due to problems in your neck or a |
| continuous pain. | | | | mixture of several different problems. Rarely, |
| Your rotator cuff is a group of muscles and | | | | shoulder pain may be caused by infection, |
| tendons that hold the shoulder joint in place and | | | | problems with the nerves, or a tumour. |
| help move the shoulder. The 4 muscles (and their | | | | Tests need to be done to determine the cause. |
| tendons) that make up the rotator cuff include: | | | | You may also need to have an X-ray, or other |
| * the supraspinatus; | | | | scans, such as an ultrasound scan or MRI. |
| * the infraspinatus; | | | | Sometimes, an arthroscopy is needed. In this |
| * the subscapularis; and | | | | test, your doctor can look inside the shoulder joint |
| * the teres minor. | | | | using a small, telescopic instrument that has a |
| Usually it is the rotator cuff tendons (the thick | | | | camera on the end. Your chiropractor will refer |
| bands of tissue that connect the muscles to the | | | | you to your doctor if necessary and a referral to |
| bones) that tear, but sometimes the tear occurs | | | | a shoulder specialist can be arranged. |