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Pro Care Physiotherapy & Athletes' Injury Center
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Address: 460 W Hunt Club Rd Unit 102A, Nepean, ON K2E 0B8

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Shoulder Conditions

Shoulder Explained

The shoulder is one of the largest and most complex joints in the human body. It is formed where the upper arm bone (humerus) fits into the shoulder blade bone (scapula) like a ball and socket. The humerus fits relatively loosely into the shoulder blade socket, which makes it vulnerable to injury.

The shoulder joint is surrounded by a set of muscles and tendons called the rotator cuff. This gives the shoulder support and allows it a wide range of motion.  The bursa, around the shoulder joint, is a sac of fluid that cushions and protects the tendons of the rotator cuff. The labrum, is a cartilage that forms a cup, in which the head of the humerus fits into.


Shoulder Conditions

There are many possible injuries that can occur to the shoulder including:

  • Rotator cuff tendonitis
  • Rotator cuff bursitis
  • Rotator cuff tear
  • Shoulder impingement
  • Frozen shoulder
  • Shoulder dislocation / separation

 

Rotator Cuff Tendonitis

Rotator cuff tendonitis is the inflammation of one of the rotator cuff tendons. It causes pain in the shoulder joint and may also send pain down the upper arm.  The rotator cuff moves within a small space called the subacromial space. When that space becomes smaller due to inflammation, bone spurs, or fluid build up, the rotator cuff tendons may be squeezed and rub against each other. This in turn will create an inflammation. Excessive, repeated and overhead movements, such as swimming, tennis, or lifting can cause this kind of injury.

With rotator cuff tendonitis, pain typically starts gradually. The shoulder will be painful when it is used, might be worse at night, and might interfere with your sleep, especially if you sleep on the affected side. Lifting the arm overhead to the side may make the pain worse.

If the injury is left untreated, the pain may become continuous and in some cases the rotator cuff tendonitis might become a small rotator cuff tear.

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Rotator Cuff Bursitis

Rotator cuff bursitis is an inflammation of the bursa, a small sac of fluid that cushions and protects the tendons of the rotator cuff.  This sac fills with excess fluid, causing pressure on surrounding tissue.

As we grow older we become more at risk of developing rotator cuff bursitis. The pain is generally most severe when using the shoulder (especially overhead) but can also be severe at night if sleeping on the affected side or with the hand kept above shoulder level.

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Rotator Cuff Tear

A rotator cuff tear is one of the worst fears of many athletes. If it is severe, a rotator cuff tear can end an athlete’s career. Most tears happen gradually, but they can also happen suddenly with a feeling of intense pain, and weakness in the arm.

Incidents that can lead to a rotator cuff tear are:

  • Too much stress can cause partial tears in the rotator cuff tendons
  • Abrupt stress can cause a complete tear in the rotator cuff tendons
  • Falling on your shoulder
  • Using an outstretched arm to break a fall
  • Lifting heavy weights
  • As we age, normal wear and tear can weaken the rotator cuff tendons

With a tear, people will usually feel pain and weakness in the shoulder and arm, and difficulty moving the shoulder, especially when lifting the arm above the head.

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Shoulder Impingement

In a shoulder impingement, the edge of the shoulder blade (acromion) presses on the rotator cuff tendons when the arm is lifted.  Repeated overhead activities, such as painting, lifting, swimming, tennis, and other overhead sports, are a major risk factor for this injury.

With shoulder impingement, activities of daily living, such as reaching up to put a blouse or coat may cause pain. If left untreated, this injury can lead to a rotator cuff tendonitis and/or tear.

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Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, occurs when you have stiffness, pain, and limited range of motion in the shoulder. This injury is said to be an inflammatory process. Frozen shoulder usually happens in stages. At the beginning, the whole shoulder joint gets inflamed which causes extreme pain. The tissues around the joint then stiffen up, scar tissue forms, and shoulder movements become quite limited and painful. The condition usually starts gradually, and then takes several months or longer to heal.

The cause of frozen shoulder is not always known, but it can also occur:

  • Because of pain or injury
  • With a chronic health condition, such as diabetes or arthritis
  • After a shoulder surgery

It has been shown that physiotherapy treatments can significantly speed up the recovery process of frozen shoulder.

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Shoulder Dislocation / Separation

A shoulder dislocation is when the humerus bone pops out of its socket following a fall or traumatic injury. When a shoulder dislocates, it must be reduced (put back in its socket) by a doctor in the emergency room. With a shoulder dislocation, other structures around the joint will likely also be injured. The shoulder will be put in a sling for a few weeks to permit the structures to heal properly and an intense physiotherapy treatment plan will be required.

A shoulder separation is a tear in one of the ligaments that connects the collarbone to the shoulder blade, following a fall or a traumatic injury.

Shoulder dislocation and/or separation might be caused by:

  • Falling on your shoulder
  • Being hit in the shoulder
  • Falling on a outstretched arm
  • Sharp twisting of the arm causing a dislocation

If you suffer from repetitive shoulder dislocations, you could wind up with chronic instability and weakness, which may ultimately require surgery.

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Can Physiotherapy Help?

Physiotherapists at Pro Care Physiotherapy & Athletes’ Injury Center can help with all shoulder conditions after performing a thorough assessment. The treatment may include:

  • Manual therapy to improve movement in your shoulder
  • Ultrasound, electrotherapy and/or acupuncture to relieve pain, swelling and promote tissue healing
  • An exercise program including strengthening and stretching to strengthen your shoulder, rotator cuff, and shoulder blade muscles, and to help you progressively return to your daily and sporting activities
  • Suggest braces and/or slings if needed for the injury
  • Massage to promote soft tissue healing and break up of scar tissue
  • Advice on posture and activities to avoid further irritation to your shoulder

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