From throwing the perfect pitch to lifting heavy objects, shoulder pain is a common problem that many travel physical therapist professionals see on a weekly basis.
Your shoulder is made up of three bones: your upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle). The head of the the upper arm bone fits into a rounded socket in the shoulder blade, which is called the gelnoid. A combination of muscles and tendons keeps your arm bone centered in the shoulder socket. However, repeated stress may strike an imbalance in the shoulder, placing increased tension on a specific area. When this happens, shoulder pain may arise.
Most shoulder problems fall into four major categories:
- Tendon inflammation (bursitis or tendinitis)
- Arthritis
- Instability
- Fracture (broken bone)
Bursitis
Bursae are small, fluid-filled sacs located in the joints throughout the body such as in the shoulder. They serve as the cushion between the bones and the overlying soft tissues, and help reduce friction between the gliding muscles and the bone.
When a patient uses the shoulder excessively, swelling of the bursa between the rotator cuff and part of the shoulder blade may create a condition called subacromial bursitis. This can make routine activities difficult, such as getting dressed or brushing your teeth.
Tendinitis
Over time, a tendon may wear down in or around the shoulder. There are four rotator cuff tendons that those on physical therapy assignments see, as well as one of the bicep tendons. Indeed, this means shoulder pain may actually stem from the bicep.
Biceps tendinitis is one such culprit behind shoulder pain. Oftentimes, this problem occurs in people who perform repetitive, overhead movements. Like other forms of tendonitis, which is an inflammation or irritation of a tendon, bicep tendonitis develops over time and may worsen with continued activity.
What is bicep tendinitis?
As any travel PT professional knows, the biceps muscle consists of two parts: the long head and the short head. The long head of the bicep is the most prevalent part affected by tendinitis, as the tendon from the muscle runs up the length of the arm and attaches into the shoulder joint, where it becomes part of the shoulder capsule, which is surrounded by a number of other structures such as the rotator cuff.
Types of tendonitis
There are two main forms of tendinitis: acute and chronic
- Acute: This results from excessive ball throwing or other overhead activities during work or sports.
- Chronic: Degenerative diseases like arthritis or repetitive erosion from age may lead to chronic tendonitis.
Arthritis
As patients age, they become more susceptible to arthritis. While there are many types of arthritis, the most common type in the shoulder is osteoarthritis, also called "wear and tear" arthritis. Medical staffing professionals will meet patients whose symptoms include swelling, pain and stiffness. Typically this occurs in people ages 45 and older.
Other types of arthritis can be linked to rotator cuff tears, inflammation of the joint lining or infection.
Instability
A sudden fall, jerk or other injury can knock the upper arm bone out of the shoulder socket. This can also occur as a result of overuse.
Notably, shoulder dislocations can be partial, when the ball of the upper arm falls partially out of the socket. Complete dislocation entails the balls exiting the socket entirely.
Besides the immediate pain from dislocation, a leading cause of this instability is that once the ligaments, tendons and muscles around the shoulder become loose, dislocations can take place repeatedly. Similar to concussions or rolling an ankle, the chances of dislocating a shoulder increase exponentially the more it happens.
Fracture
Shoulder fractures, which are broken bones, cause severe pain and bruising around the shoulder. Older patients may break one of the three bones in the shoulder as a result of falling. In younger patients, it may be caused by a high-energy injury, including football collision or motorcycle accident.
Depending on the original cause behind shoulder pain, travel physical therapy professionals can develop a specialized treatment program to help patients heal, strengthen muscles surrounding the shoulder and reduce risk of repeated injury.