Shoulder Pain

Shoulder pain can result from various underlying conditions affecting the shoulder joint, muscles, tendons, or ligaments. The shoulder joint, comprised of a ball-and-socket, is the most mobile joint in the body. However, because of its vast range of motion, it is also unstable. It is supported by soft tissues, which are also subject to injury, overuse, and under-use.

Shoulder pain can significantly impact your day-to-day activities and quality of life. Early diagnosis and appropriate treatment, tailored to the specific condition and severity of symptoms, are essential for optimal outcomes.

At Impact Sports & Spine, we use advanced diagnostic ultrasound to help determine the underlying cause of your shoulder pain before designing a personalized treatment plan. Our team focuses on non-surgical and minimally-invasive treatments for optimal healing, ensuring minimum complications and faster recovery.

Understanding Shoulder Anatomy

The shoulder is a ball-and-socket joint made up of three main bones: the humerus (long arm bone), the clavicle (at the collarbone), and the scapula (also known as the shoulder blade).

The shoulder girdle in its entirety consists of three joints: the shoulder joint proper (glenohumeral joint), the acromioclavicular (AC) joint, and the sternoclavicular (SC) joint. The shoulder joint/glenohumeral joint is the primary joint, where the long arm bone fits into the rounded socket of the scapula. The AC joint is located at the top of the shoulder. It is where the clavicle (collarbone) meets the acromion, a bony projection of the scapula. The SC joint is located in the front of your chest, where the collarbone meets the breastbone (sternum).

The glenohumeral joint is held together by the rotator cuff, which is a group of muscles and tendons that protects the humerus and allows arm movements. Additionally, various other ligaments, muscles, and tendons provide essential stability and movement to the shoulder, ensuring proper function and preventing dislocation.

Injury to any of these components of the shoulder can cause shoulder pain, typically due to overuse, injuries, and repetitive activities. Degenerative diseases may also cause shoulder pain that travels along nerves to the shoulder.

Common Causes of Shoulder Pain

Shoulder pain can result from overuse, repetitive movements, trauma, nerve compression, and poor shoulder posture.

Shoulder Impingement

Shoulder impingement, also known as impingement syndrome, occurs when the rotator cuff tendons or bursa in the shoulder are compressed or pinched during arm movements. This condition can cause shoulder pain, inflammation, and restricted movement.

Shoulder impingement syndrome can include:

Rotator cuff tendinitis: Refers to the inflammation of the tendons in the rotator cuff
Shoulder bursitis: Involves inflammation of the bursa, the fluid-filled sac that cushions the space between your rotator cuff tendons and acromion
Acromion deformity: The acromion is usually flat, but if it is curved or hooked, it can rub or pinch the rotator cuff and cause shoulder impingement

Rotator Cuff Tendinosis/ Partial Tears

Rotator cuff tendinosis refers to the degeneration of the rotator cuff tendons, leading to shoulder pain. This condition is caused by repetitive overhead activities, shoulder trauma, age-related degeneration, and impingement.

Rotator cuff tendon partial tears involve damage to one or more of the tendons that make up the rotator cuff. These tears can be caused by acute injury, chronic overuse, or degenerative changes.

Adhesive Capsulitis

Adhesive capsulitis, also called frozen shoulder, is a condition characterized by stiffness and pain in the shoulder joint. It is caused when the capsule of connective tissue surrounding the shoulder thickens and tightens around the joint, restricting movement and causing shoulder pain.

Glenohumeral Joint Arthritis

Glenohumeral joint arthritis involves the degeneration of the cartilage in the shoulder joint. It can lead to shoulder pain, stiffness, and reduced mobility.

Glenohumeral joint arthritis can develop from wear and tear of cartilage, chronic inflammation, injuries like fracture or dislocation, and severe rotator cuff tears.

Acromioclavicular Joint Arthritis

Acromioclavicular (AC) joint arthritis involves the degeneration of the cartilage in the AC joint, leading to pain, stiffness, and reduced shoulder mobility. It can develop from wear and tear, inflammation of the joints, overuse, fracture, dislocation, or severe sprain.

Sternoclavicular Joint Arthritis

Sternoclavicular (SC) joint arthritis involves the degeneration of the cartilage in the sternoclavicular joint, where the clavicle meets the breastbone. This condition can cause pain, swelling, and limited shoulder and chest movement.

Acromioclavicular Ligament Sprains / Partial Tears

Acromioclavicular (AC) ligament sprains and partial tears involve injury to the ligaments that stabilize the acromioclavicular joint. These injuries are common in athletes and people who engage in activities that involve repetitive overhead movements or direct impact on the shoulder.

Coracoclavicular Ligament Sprains / Partial Tears

The coracoclavicular ligaments are essential for stabilizing the AC joint. Sprains or partial tears of the coracoclavicular ligaments typically occur due to trauma or overuse, leading to instability and pain in the shoulder region.

Glenoid Labrum Tears

The shoulder socket, also called the glenoid, is surrounded by a thick line of cartilage-like tissue called the labrum. A glenoid labrum tear can occur after an injury, trauma, or performing a repetitive movement with your shoulder.

Biceps Tendinopathy

Biceps tendinosis affects the tendon of the biceps muscle, particularly where it attaches to the shoulder or the elbow. It can involve inflammation, degeneration, or tears of the tendon, leading to reduced shoulder or elbow function and shoulder pain.

Nerve Entrapments/Impingements (Axillary Nerve, Dorsal Scapular Nerve, Suprascapular Nerve)

Nerve entrapments or impingements are conditions where nerves become compressed or irritated, leading to pain, weakness, numbness, or tingling sensations along the affected nerve pathway.

Axillary nerve entrapment: Compression of the axillary nerve can lead to weakness and numbness in the shoulder and upper arm
Dorsal scapular nerve entrapment: Can result from trauma, repetitive activities, or compression, leading to weakness and pain in the upper back and shoulder blade area
Suprascapular nerve entrapment: Can cause shoulder pain and weakness, particularly in the supraspinatus and infraspinatus muscles

Symptoms of Shoulder Conditions

Pain in the shoulder may be localized in a specific part or radiate to areas around the shoulder or down the arm. Symptoms of shoulder conditions can vary depending on the underlying cause.

Common symptoms include:

Mild ache to sharp pain in the front, back, or side of the shoulder
Reduced ability to move the arm
Stiffness in the shoulder joint
Difficulty lifting or rotating the arm
Swelling and tenderness around the shoulder joint
Feeling of the shoulder being loose
Decreased strength and weakness
Sensations of numbness and tingling
Pain radiating to the arms

Diagnosis & Treatment of Shoulder Pain

Our doctors perform a comprehensive assessment of your shoulder to determine the underlying cause of the pain. We begin by discussing your medical history and symptoms, including the nature of the onset and duration of your pain. This helps us understand any activities or injuries that might have contributed to your condition.

We perform a physical examination to assess your shoulder's range of motion, strength, stability, and areas of tenderness. We may also use a diagnostic ultrasound to visualize the soft tissues around the shoulder, such as muscles, tendons, and ligaments, to pinpoint the condition that may be causing your shoulder pain. When needed, we may ask for additional imaging tests.

Upon identifying the underlying cause of your shoulder pain, we recommend appropriate treatment to reduce pain and improve function. Treatment options may include rest and/or activity modification, ice and heat therapy, physical therapy, minimally-invasive non-surgical procedures, and surgical referrals. Our treatments are personalized and tailored to your goals.

Prevention Tips for Shoulder Pain

Although you may not be able to avoid unforeseen injuries and age-related degeneration, you may still reduce the risk of shoulder issues with a combination of proper techniques, exercises, and lifestyle adjustments.

Consider following these tips to help prevent shoulder pain:

Focus on strengthening the rotator cuff muscles
Perform stretching exercises to maintain flexibility
Use proper lifting techniques to avoid shoulder strain
Use correct form and techniques during sports
Use appropriate protective gear, such as shoulder pads
Setup your workstation ergonomically
Maintain good posture so that your shoulders are relaxed and not hunched
Take regular breaks from repetitive activities
Always warm up before high-intensity activities
Perform cool-down exercises after high-intensity activities

Treatment for Shoulder Pain at Impact Sports & Spine

Persistent shoulder pain can affect your quality of life by causing difficulty in performing daily activities. We provide personalized care for shoulder pain after a thorough evaluation of the affected area.

At Impact Sports & Spine, we focus on providing high-quality non-surgical care for acute and chronic musculoskeletal injuries and spinal conditions. Our team focuses on uncovering the root cause of your condition rather than merely treating the symptoms.

To schedule a consultation with our skilled practitioners, call us at 301-363-9693 or request an appointment online.