Shoulder pain is a common affliction that affects many
people on a daily basis. Depending on the severity of the
pain this type of problem can have a significant, negative
impact on performing your occupation and your activities of
daily living. There are several ways that shoulder pain
can develop and I will discuss those below.
The most recognized way for pain to develop in the shoulder
is through trauma. This could consist of something obvious
like falling onto your outstretched arm causing your
shoulder to jam or trying to push or pull on a stuck
object. A less obvious traumatic event could be
forcefully using the muscles of the shoulder over time and
then pain occurs. This could happen during activities such
as chopping firewood, hammering, or exercising in a
repetitive fashion. The first traumatic event is
identified as a macrotrauma meaning it's a large and
obvious event. The second situation is termed a
microtrauma meaning it's less obvious and occurred with
repetitive insults to the muscle tissue. One does not
necessarily occur more than the other, but both can cause
significant injury and pain.
The macrotraumatic event can lead to injury of the muscle
by causing a major tear in the muscle fibers. A muscle
tear is exactly what it sounds like. The muscle fibers
actually rip apart and become separated from each other or
where the muscle tendon inserts on a bone in the shoulder.
You can have different size tears and these are usually
termed partial, full or full thickness tears. It is
important to remember that just because a muscle tear is
present that doesn't always mean you will have to have
surgery. Signs that a shoulder muscle is torn include but
are not limited to pain, weakness, and loss of motion.
A microtraumatic event or repetitive overuse can lead to
injury of the muscle by causing minor tears in the muscle
fibers. These are small in degree but enough to cause an
inflammatory process to occur which leads to pain. This is
a condition that we would commonly term as tendonitis (an
inflammation of the muscle or tendon). It is not the same
as a partial or full tear. The muscle fibers do not
actually separate from each other. This type of event can
cause significant pain and dysfunction. Signs that a
shoulder muscle is inflamed include but are not limited to
pain, weakness, and loss of motion.
Another common cause of shoulder pain is bursitis. A bursa
is a fluid filled sack that sits between muscle and bone.
The bursa is designed to protect the muscle from scraping
against the bone, thus it protects it from becoming
irritated against the bone. The bursa has a lot of nerve
endings in it. If the bursa becomes inflamed we term this
bursitis and it can be very painful. A bursitis can occur
in the shoulder as the result of a macro or microtraumatic
event as described above just like a muscle tear or
tendonitis can develop. Signs that a shoulder bursa is
inflamed include but are not limited to pain, weakness, and
loss of motion.
These are three of the most common pathologies that cause
pain in the shoulder. You will notice that the symptoms
that you may experience as a result of these conditions are
very similar. So how do you tell which problem you may
have? Well, to determine that you should consult a
competent Physical Therapist in your area that specializes
in the evaluation and treatment of musculoskeletal and/or
orthopedic pathologies. They will be able to successfully
diagnose the source of your pain and treat the problem
appropriately.
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Peter Harris is a licensed Physical Therapist with 17 years
experience in the profession treating patients with
shoulder pathology. Learn how I have helped hundreds of
patients with shoulder problems overcome their pain and get
their life back!
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