NOVEMBER FOCUS – SHOULDER PAIN

The shoulder joint is a complex of joints. There is the ball and socket joint which provides the ability to move in many directions. Then there are smaller joints providing a connection/articulation with the collar bone, shoulder blade and ribs. Each area has different requirements for movement and stability.

As well as these bony connections, there are many ligaments, tendons and muscles that surround the shoulder complex. Providing power, movement and stability to the region, but also connecting to adjacent areas like the neck, upper back and arm.

It is more often than not, when receiving Osteopathic evaluation and treatment. That all these areas will be considered and assessed together.

Mechanical shoulder pain occurs for a multitude of reasons, these include: Sporting injuries, postural issues, stress and tension problems, ligament and tendon damage and muscular strains. Common shoulder problems are dislocation, separation, rotator cuff tear, frozen shoulder, fracture, arthritis, bursitis and tendonitis.

Shoulder pain can also be a result of problems at the gallbladder and liver. Possibly pain can be related to the heart, or perhaps referred from the neck.

If you are visiting an Osteopath about your shoulder pain, expect to run through a case history detailing the onset, and characteristics of the problem. (This will also include a general medical history.) Followed by an examination of your body and shoulder position. Alongside shoulder movements and any further tests that may be indicated.

Treatment would address the tissues that cause the problem, and might also work elsewhere in order to reduce any potential strain on the shoulder. Treatment includes specific soft-tissue massage, and a wide variety of joint mobilisation techniques.

The following are some basic mobilisation and strengthening exercises.
If you are experiencing pain, you should get the area assessed properly by an appropriate professional, to make certain what is the right course of action for you.

Shoulder mobilisation against a wall
This can be useful as a gentle exercise when your shoulder needs a little support whilst moving. Stand face onto a wall with your arm extended out in front of you so the fingertips can rest on the wall. Walk your fingers up the wall, repeat 5 times. You could also draw circles on the wall in and anti-clockwise and clockwise direction. Try 5 each way. This can be performed at any level that feels comfortable for you.
The same can be performed standing side-on to the wall, but with the arm extended side-ways to carry out the same exercise. Therefore encouraging a different range of motion.

Side-lying Shoulder Mobilisation
Lay on your side and draw as bigger circle as you can with one
arm. Try as much as possible to keep the hips stacked on top of

one another to try and focus the movement higher up. Repeat 5
times.

Elbow circles
Place your hand on the shoulder of the same side. Your elbow should be bent and out to the side of your body. Think about drawing a circle with your elbow out to the side. Repeat 5 times in a forward direction and 5 times in a backwards direction. Try and keep your body and shoulders facing forwards when you perform this exercise.

“Towel drying” exercise
Using a scarf, hold onto one end, and place this hand behind your lower back. With the scarf at the back of your body. Hold the opposite end with a bent arm above your shoulder. Use the upper arm to gently pull the lower hand up your back. This encourages a rotation movement in the shoulder. Repeat gently 5-10 times.

Biceps strength
Stand on one end of a length of elastic exercise band. Hold onto the other end, bring your elbow into your side. With your palm facing upwards, bend the elbow to bring the hand towards the shoulder. Make sure the band is taut to get good resistance. Try 10-12 repetitions, rest and repeat. (Using a weight in the hand would also work.)

Shoulder Abduction Strengthening
Standing on one end of a length of elastic exercise band, hold the opposite end in your end. Raise your straight arm up to the side of the body. Making sure the band is taut to provide resistance. Repeat 10-12 times. Rest and repeat. (This exercise could also be performed with a weight as an alternative.)

Rotator Cuff Strengthening

Hold an elastic exercise band ahead of you at waist height. Either grip one end of the band, or attach it to some furniture, e.g. a doorknob might well be at a good height for this.
With the opposite hand. Keep your elbow close to your body and move the forearm out and backwards in an arc-like motion.

To work other aspects of the rotator cuff. Either keep one end of the exercise band attached to a doorknob. Then with the elbow into the side. move the hand against resistance in an arc-like motion towards the abdomen. This could also be performed with the band around your back and brought to the front to be held at both ends. Fixing with one hand, and performing the exercise with the opposite hand.
Try these exercises for 10-12 reps, and repeat twice.