Over the past few weeks i have seen a variety of shoulder injuries walk through the door. Sometimes as a result of a sporting injury or others due to changes in load in a training program. Over the next few weeks we will look at each of the injuries below- the mechanism of injury, the structures involved, assessment, treatment and prognosis. For now, here is a little taster of some of the injuries we see here at Physiotherapy in Motion Perth in Osborne Park.
Anatomy of the Shoulder
The shoulder is one of the bodies most complex structures. Compromised of three joints. The glenohumeral joint (ball and socket), acromioclavicular joint (ACJ) and scapulothoracic joint (your shoulder blade). These structures are surrounded by muscles, joints, tendons, ligaments and cartilage. If injured any number of these structures can lead to pain, discomfort and restriction of movement.
The rotator cuff is a group of four muscles (Supraspinatus, Infraspinatus, Subscapularis and Teres Minor) that surround the glenohumeral joint with the primary function of dynamic stability. Due to the way the tendons insert onto to bone their roles are highly interrelated.
Supraspinatus: Primary Function= Abduction
Infraspinatus: Primary Function= External Rotation
Teres Minor: Primary Function: External Rotation
Subscapularis: Primary Function= Internal Rotation
Rotator Cuff Tear
The rotator cuff tendons can be prone to tears, either through acute injury or degenerative changes. This can directly affect mobility, strength and your ability to complete both everyday and sport related activities.
Sub Acromial Pain Syndrome (SAPS)
Is a diagnosis that is used to describe a non-traumatic shoulder pain and may include a range of potential structures within the sub acromial space that may be contributing to your symptoms. Including the sub acromial bursa, rotator cuff tendons and the long head of biceps. You may notice pain when lifting your arm to the side or up above your head.
Usually occur as a result of a traumatic injury, the shoulder can “pop” out forwards (anteriorly) or backwards (posteriorly), it is often very painful and requires urgent medical attention to relocate the shoulder.
Labral Tear (SLAP Tear)
SLAP tears are injuries that occur to the labrum (the cartilage within the shoulder) with the biceps tendon often being involved.
The acromio- clavicular joint is comprised of the distal end of the clavicle (collar bone) and the acromion. It is often injured through a traumatic event such as falling on to an outstretched arm. Sometimes a deformity can be seen or palpated as the distal end of the collar bone can may be raised.
Subjective: A detailed history needs to be taken to help the clinician determine the source of symptoms, the mechanism of injury and any other medical conditions or previous injuries need to be explored to determine if they are having impact on the patients symptoms.
Objective: Range of movement, strength, sensation, posture, motor patterns are just some of the things that will need to be assessed to help determine the source of symptoms.
Depending on the injury, there a range of treatments that may prove to be beneficial in reducing pain and restoring full function of the shoulder. These can include massage, joint mobilisation, dry needling, taping, rehabilitation programs and in some cases post-operative rehabilitation programs. Each treatment plan being specifically
Next week we will specifically look at Labral Tears (SLAP)- the anatomy, symptoms, assessment, treatment and rehabilitation exercises.
Physiotherapist and Exercise Physiologist
Owner Physiotherapy in Motion Perth
7/97 Hector Street West, Osborne Park 6017