The shoulder is the most flexible joint in the body. The ball of the humerus rotates in the socket of the scapula, allowing us to move our arms in a myriad of different directions with precision and relative ease. However, this freedom of movement comes at the sacrifice of stability. This is one of the reasons why the shoulder joint is the most frequently dislocated joint in the body. The muscular support for the shoulder is primarily provided by the deep muscles called the rotator cuff: a collection of four small muscles whose role is to stabilise the ball within the socket, and to control fine movements within the joint. The larger external shoulder muscles such as the deltoids, pectorals, and biceps help us to perform various coordinated arm movements. At times, an imbalance between the strength of the deep stabilising rotator cuff muscles and that of the larger external muscles can place strain on the joint and lead to injury. The shoulder is attached to the torso by the clavicle in the front and the scapula in the back. The scapula is held in place on the upper back by large muscles which attach to the rib cage and the spine. It plays a very large role for the shoulder joint by transferring the forces from our torso and legs to allow for powerful full body movements as when bowling in cricket.
Shoulder pain can come in many forms and can be due to repetitive movements or acute injury. It is commonly worsened by movements such as overhead reaching, pulling a wallet from a back pocket, or trying to fasten a bra. Often it is accompanied by weakness. Shoulder pain can be referred from the neck, or even certain internal organs, so we perform a full screening to discern where the pain or weakness is coming from to be able to treat the cause rather than just the symptoms.
Treatment is aimed at restoring the natural movement, strength and function at the source of the pain. Hands on treatment is aimed at improving the mobility of the joints and clearing any muscular restrictions. Exercises are utilised in an attempt to regain flexibility and strength to allow the individual to return to their usual activities without pain or limitations.