The most commonly injured structures in the shoulder are the tendons, the ligaments followed by the bursa. What are these things and what do they do??
The tendons are what attach our muscles to our bones allowing movement. The shoulder is a highly mobile, flexible complicated joint. The tendons are loaded in extreme ranges of motion and due to the anatomy of the shoulder complex often run “through” boney tunnels and above/below other muscles. Imagine the tendon like a rope, imagine for whatever reason the boney complex changes shape (extreme ranges of motion, period of inactivity, loss of muscle mass…etc etc) the rope no longer “fits” through the tunnel without rubbing. Using the rope analogy, rubbing along a firm surface long enough will cause fraying… tearing.
Sounds very dramatic doesn’t it?
These injuries can occur over time, as a form of wear and tear or in response to a fall/awkward position.
What do we do about it?
Years ago we would of prescribed mountains of therband exercise. Lots of rotating your arms about… read: boring rehab. BUT now we understand that treating the cause is the most important way to unload the injured area. To do this we have to find the cause (sometimes easier said than done, but not often!).
Ligaments connect our bones to other bones. There job is to provide stability and energy transmission. They commonly require a significant force to injure them. In the shoulder, lacking ligamentous integrity leads to instability, excessive movement. With this comes wear and tear in the joint, altered movement patterns and as such loading of structures that aren’t prepared. This can cause injury to the tendons… round and round we go.
Bursa are clever additions to our body. We liken them to little water balloons. They sit over many boney prominences in our body to protect the tendons/ligaments/muscles from the bone. We commonly see referrals for treatment of bursitis. Again, years ago we would of quickly turned to cortisone injection for treatment. Now, we understand we need to fix the cause of the excess load on the bursa for any treatment to be effective long-term.
Finding the cause.
We look at your posture, how you move and not just your shoulder. We ask about what your shoulder needs to do. Are you a marathon swimmer? Or a Mum, lifting toddlers in and out of cars? What are your goals? And how much is this pain/dysfunction impacting your life?
Next, we try to alter how you move or how you sit or your posture. Even temporarily to prove we can change the pain, that’s half the battle.
Physio has evolved so much over the last decade. Make sure your therapist is finding the CAUSE and not wasting your time (or $) on treating the EFFECT.
Can we help? Call us 8544 8484
#physiocronulla #shoulderrehab #loveyourlife