Problems Of The Shoulder 
The shoulder girdle comprises three joints, which may be affected by arthritis. This includes the (#A) Sternoclavicular Joint, (#B) Acromioclavicular Joint and (#C) Glenohumeral Joint. Please look at Illustration #1 for a visual guide. In addition, an of the soft tissues may be affected by degeneration in the shoulder area. Sometimes, it is tricky to determine the problem that is affecting the shoulder. If you look at the Illustration #2, you may note some typical pain patterns. a. Bicipital Tendinitis - This is the pain produced by the biceps tendon rubbing in the groove of the arm bone (humerus). b. Arcomioclavilar Joint Pain - The acromioclavicular joint is the joint between the collarbone and the acromial portion of the shoulder blade c. Sternoclavicular Joint Pain - This pain is produced by problems between the sternum (breastbone) and the collarbone. d. Glenohumeral Joint/Rotator Cuff/Subacromial Bursitis pain - This pain pattern can be produced by problems between the humerus and the shoulder socket or the rotator cuff muscles and bursa. Typically, conservative treatments is tried first such as therapy to reduce pain & symptoms and restore normal function for the patients. Most arthritis problems come on slowly, whereas most rotator cuff problems come on rather suddenly. The pain from shoulder arthritis is usually more persistent and severe than rotator cuff problems. Treatment - The first goal in therapy is to try to reduce pain. We use treatment modalities such as: ice or heat, phonophoresis (cortisone cream with ultrasound), Iontophoresis (E-Stim with Dexamethasone) and Electrical Stimulation. Once the pain is reduced, gentle range of motion exercises begin. If range of motion improves enough, strengthening may begin. We try to strengthen muscles to stabilize the shoulder. This may prevent pain and symptoms from returning. If therapy is unsuccessful, surgery may be necessary. Nerve problems need to be ruled out if symptoms persist. Listed on the next page are key points to help protect your shoulders from injury and pain: · Respect pain. While doing any activity, if it becomes painful, stop. If pain persists during activities, please see your doctor. · Balance activities. If your job involves heavy labor with your arms, choose hobbies that don’t repeat the same heavy activities. · If you don’t have pain but want to help prevent future injury, see a qualified personal trainer or therapist. They can train you to strengthen the proper muscles to avoid injury. · A personal trainer or therapist may also help you to learn the appropriate stretching for proper shoulder flexibility. · Avoid excessive overhead activities. · Most shoulder problems present particular pain patterns, see illustration #1 page one. · Arthritis problems come on slowly. Tendonitis of Burstis come on quickly. · Pain with resistance to the muscles affected usually indicates arthritis. · Therapy to deflame the shoulder can be a useful adjunct to pharmalogical intervention waiting for therapy later may deepen and intensify symptoms. · Ergonomics may play a factor in pain development. |
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