Shoulder pain is a frequent complaint that I see in my patients daily and something that everyone experiences at least once in their lives. The shoulder needs to be one of the most mobile joint’s in the body as it is used from the minute we wake in the morning to the time we fall asleep at night, as well as fairly frequently while we sleep! Therefore pain, tightness or loss of motion in the shoulder or in surrounding areas causes significant problems in a patient’s daily life.
Common shoulder problems arise from muscles, ligaments and tendons of the shoulder and surrounding area not performing as they should. Typically they cause numerous problems in patients being unable to perform daily activities such as reaching overhead. Many patients come to the clinic after months of ignoring their pain which results in a worsening of symptoms and a longer recovery time. It is always best with all new pains to seek treatment sooner rather than later so as to avoid potential chronic and debilitating injuries which take longer to resolve.
Common shoulder complains are due to impingement, instability, muscular/tendon tears, bursitis, tendonitis, arthritis and adhesive capsulitis.
Impingement simply means the muscles of the shoulder become trapped underneath bone when performing particular movements such as overhead activities. Osteopathic treatment of impingement in the shoulder will typically involve reducing inflammation cause by muscles being impinged, increasing the mobility of the bones located near the shoulder so they do not trap muscles and reducing painful points within muscles. By addressing these 3 points shoulder pain can be significantly reduced after only a few treatments.
Instability of the shoulder is typically caused by weakness in surrounding muscles which leaves the shoulder more vulnerable when carrying out movements. Symptoms of this typically involve a feeling of giving way with certain movements and a possible history of shoulder dislocations. Treatment for patients with this particular problem involves strengthening the muscles that hold the arm into the shoulder socket. By addressing this, the shoulder becomes more stable, which in turn decreases pain associated with an unstable shoulder.
Muscular or tendon tears can be caused by an acute, sudden injury, such as throwing a ball overhead or a chronic injury from repetitive wear and tear. They can also be a partial tear or a complete rupture. Complete ruptures typically have to be surgically resolved whereas partial tears usually only need time to heal. In both these cases osteopathy can greatly improve recovery time and further damage to the area.
Bursitis is a common shoulder condition involving fluid filling bursa becoming inflamed and swollen. Bursas are located throughout the body and act as a cushion between bone and muscle to reduce direct friction occurring when muscle tendons glide under these bones. Typical symptoms patients report are heat and swelling at the shoulder, reduced range of motion and tenderness to touch particular points on the shoulder. Osteopathic treatment will involve reducing the inflammation of these bursae by reducing the impact of tendons and muscles moving across them, as well as advice on limiting repetitive use in this area.
Tendonitis is similar to bursitis as it involves inflammation, however in this case it involves the tendons of the shoulder instead. Causes can be either acute or chronic such as repetitive overhead activities or general wear and tear due to old age. Symptoms include an aching sensation deep in the shoulder as well as a history of repetitive overhead activities such as throwing in sports, painting and swimming. Treatment for tendonitis of the shoulder is the same as bursitis as we will focus on limiting the stresses on these tendons and address the cause of the problem and way of limiting reoccurrence.
Arthritis of the shoulder is typically seen in older patients, those with a previous trauma or surgery to the shoulder, and those whose occupation or daily activities involve repetitive overhead movements. All of these causes create a continuous wear and tear cycle to the shoulder which over time leads to arthritic changes to the joint which worsen over time. Symptoms involve pain, stiffness, swelling and a reduction in range of motion. Although arthritis is a condition that cannot be reversed, osteopathy will help to reduce pain caused by the arthritis and help you to be able to continue to live an active life and minimise any further wear and tear to the joints.
Adhesive Capsulitis is a condition that severely affects shoulder range of motion making it extremely stiff and immobile. A specific cause of this condition is still unknown and can take anywhere from 6 to 18 months to resolve. Being such an unknown condition and having such a long recovery time, it can be overwhelming for a patient once diagnosed. Osteopathic treatment can help with maintaining the existing range of motion of the shoulder and in turn improve healing and recovery time.
Osteopathy views and treats the body holistically. This means rather than focusing on one particular area such as the shoulder, we instead assess and treat other areas of the body than can be contributing to the problem such as the spine, the neck, ribs, collar bone and shoulder blade. This results in faster diagnosis of the main cause of your pain as well as a quicker recovery.
Osteopathy has proven benefits for patients with shoulder pain and this has been shown in multiple studies. An article in the Journal of the American Osteopathic Association showed that patients treated with osteopathy had an increase in range of motion and decrease in pain with their shoulder complaints (Knebl, 2016).
Techniques commonly used to treat shoulder problems include soft tissue massage, muscle stretching, ligament balancing, manipulation and mobilisation of surrounding joints.
Dr Emma Kopcikas, is an Osteopath at Vibe Natural Health Grange in North Brisbane. She practices Monday to Saturday and you can read more about Emma here.
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(1) Knebl, J.A et al. “Improving Functional Ability In The Elderly Via The Spencer Technique, An Osteopathic Manipulative Treatment: A Randomized, Controlled Trial”. The Journal of the American Osteopathic Association 102 (2016): 387-396. Print.