Shoulder pain ? What are the different shoulder pains ? When do you come to consult your osteopath for your shoulder ?
The painful shoulder
Osteoarthritis, also called osteoarthritis of the shoulder. It refers to an alteration of the cartilage of a joint between two bones. The joint concerned is then the one that includes the shoulder blade and the upper end of the arm, called the head of the humerus. The wear of the cartilage at this so-called glenohumeral joint causes pain in the shoulder, because the two bone pieces are then in contact.
•Variable and intermittent shoulder pain due to inflammation.
• Pain when moving the shoulder (especially when rotating)
•Temporary blockages of the shoulder joint.
•Progressive stiffening of the joint.
Rupture of the rotator cuff
Rupture of the rotator cuff refers to damage to one or more shoulder tendons
There are 3 types of rotator cuff tears:
Due to the natural wear of tendons with age
Traumatic rupture following a trauma
The trophic rupture which can be consecutive to a false movement, a simple harmless gesture.
Symptoms: There is especially a disorder of the shoulder function which results in a limitation of movement.
Shoulder subacromial impingement
It corresponds to an abnormal friction between the acromion and the upper part of the humor. It occurs mainly during a lifting effort at shoulder height, i.e. 90° of anterior elevation or in abduction.
It is a frequent cause of consultation for anterior shoulder pain.
His diagnosis: on clinical examination, we look for a painful grip felt when the head of the Humerus comes into contact with the acromion.
Treatment: 2 arms glued to the body, hands holding a cane in front of you horizontally. Without any movement you push and pull alternately as if to extend or compress the rod in sequences of 10 seconds.
Slap shoulder injury (torn arm)
It is an attack of the upper part of the Labrum and the associated tendon. The Labrum is torn and is associated with a rupture of the tendon of the long Biceps.
Mild to moderate pain during certain shoulder movements.
Feeling of discomfort inside the shoulder.
Shoulder more or less unstable.
Loss of strength in the shoulder and arm.
Loss of speed when throwing.
Slap adhesive capsulitis=frozen shoulder
Adhesive capsulitis is an inflammation of the shoulder capsule.
Permanent pain in the shoulder.
Disappearance of rigidity then reappearance of shoulder mobility.
Causes: severe fatigue, local trauma stress such as a fall.
Treatment: Immobilization by splint or cast.
Cause: It is linked to the accumulation of calcium within one of the tendons of the rotator cuff.
Often seen in adults between 30-50 years old.
Symptoms: Calcifying tendinopathy of the shoulder is manifested by inflammatory pain, often inseminating and which can be exacerbated when the calcification appears or disappears. The first treatment to be offered is a drug treatment including analgesics and anti-inflammatories.
Dislocation and instability of the shoulder
Acromioclavicular dislocations are linked to sports accidents but also on public roads, following a direct impact on the shoulder, by contact or fall. Contact sports (rugby, judo, etc.) are particularly implicated in this type of dislocation.
Symptoms: The patient mainly notices pain and functional impotence, as well as bruising, edema, deformity of his shoulder with a protrusion of the clavicle under the skin, depending on the stage of severity of the dislocation.
Inflammation of a tendon.
Symptoms: Pain and difficulty performing movements that are usually basic and easy.
Shoulder of the throwing athlete
This is a posterosuperior shoulder impingement. It explains most shoulder pain in athletes performing throwing movements. If this contact between the deep face of the cuff and the post edge of the glenoid is physiological, the repetitiveness of arming movements is a predisposing factor to the lesions highlighted.
Treatment: stopping the sport will stop the symptomatology, arthroscopy.
Risk factors for shoulder pain
Certain professional activities promote musculoskeletal disorders and in particular shoulder injuries because the joint is under heavy strain.
This is the case when:
The work imposes posture constraints (work carried out with arms in the air or hands stretched in front of the body or above the shoulder).
Harmful gestures such as raising the arm are frequently repeated.
Professional activity requiring significant muscular efforts of the shoulder associated with carrying heavy loads, even infrequently.
Certain sporting activities using the gestures of arming and throwing (handball, volleyball, javelin, tennis…) or activities at risk of trauma (rugby, football, judo…) are responsible for injuries resulting from microtrauma linked to overuse of the joint.
Adopte the right daily gesture
You will limit by dressing the painful side first, which will save you from having to contort your sensitive arm. To undress, on the other hand, start with your good shoulder and end with the one that makes you suffer.
At night, to sleep better prefer the position on the back or on the opposite side. If necessary, place a pillow under your aching arm, a tip to avoid tension when you wake up.
Practice of strengthening exercices
You will keep these ailments at bay by regularly practicing stretching exercises:
Sit down with your back straight, facing the leaf of a door held between your knees.
Place a rubber band around the handles and hold the ends.
Pull the elastic towards you by lowering the shoulders and squeezing the shoulder blades.
Hold the position for 6 seconds, before slowly releasing.
Repeat the exercise 10 times.
Sitting on a chair with your back straight, put a rubber band or tie a scarf around your wrists. Keeping your elbows well glued to the body, try to spread your forearms by fighting against the resistance of the link.
Hold the position for 6 seconds, then release.
Repeat the exercise 10 times.
The value of osteopathic treatment in painful shoulder
In the case of tendonitis, the interest of the osteopath will focus on the joints of the shoulder but also the elbow. He will test and treat, if necessary, the cervical to ensure not only optimal mobility in order to avoid additional tension on the shoulder muscles (the same for the thoracic vertebrae and the ribs) but also to optimal innervation of the muscles by eliminating any nerve compression that may exist.
If it is a tendon rupture, the osteopath is an important post-operative actor to work on the fascias as well as the arthroscopic scars in order to avoid the establishment of adhesions. Then, he also has a role to play in the recovery of shoulder mobility thanks to his techniques in addition to rehabilitation with a physiotherapist which is absolutely necessary.