Shoulder pain is caused by one or a combination of these three main causes…
Rotator Cuff Impingement
Shoulder impingement is when the space between your rotator cuff and acromion narrows and increases pressure to the rotator cuff causing impingement when you raise your arm. Impingement is typically caused by overuse; repeated use of the shoulder can make your tendons swell, leading them to catch on your acromion.
The shoulder joint is the most mobile joint – no wonder why shoulder stability and strength is so important!
People who are at risk for impingement include:
- Sports that include constant overhead movements including: swimming, baseball and tennis.
- Occupations that require a lot of heavy lifting or repetitive movements.
- Those who sit at a desk for extended periods of time and tend to have shoulders rounded forward
You have possible shoulder impingement if you have these symptoms:
- Pain when you raise your arm
- Weakness of the shoulder
- Pain that goes from the front of the shoulder to the side of the arm
The labrum in your shoulder is a piece of fibrocartilage that lines and reinforces the glenohumeral joint (or shoulder socket). The labrum is the attachment site for the ligaments and supports the ball and socket joint along with the rotator cuff and other surrounding musculature of the shoulder. It contributes to stability, and when torn, can lead to partial or complete shoulder dislocation.
Types of labrum tears in the shoulder:
- SLAP tear or lesion
“SLAP” stands for superior labrum anterior and posterior. The tear occurs in the top, or superior, area of the labrum, where the biceps tendon is attached, frequently causing the biceps tendon to be injured as well. Typically, if this tear is not severe then it can typically be treated conservatively with physical therapy and exercise.
- Bankart tear or lesion
Bankart tear typically occurs when someone sustains a shoulder dislocation. As the shoulder dislocates and comes out of the socket, it often tears the labrum especially in younger people.
- Posterior labrum tear
This is extremely uncommon, but if you have injury to the back of the shoulder it can cause a posterior tear.
Symptoms of a labral tear:
Causes of labral tears:
- Overuse of the shoulder
- Frequent overhead movements
- Falling onto an outstretched arm
- Direct trauma to the shoulder
Another common cause of shoulder pain is a pinched nerve from the cervical spine, also known as cervical radiculopathy. A nerve can become pinched from a number of reasons including: when too much pressure is applied to a nerve from surrounding tissues such as muscles or tendons, bone or ligaments. Aside from tissue restrictions, nerves can become pinched from changes in the spine such as herniated or bulging discs. There are three main nerves that go from your cervical spine down to your hand: ulnar nerve, median nerve and radial nerve. It is likely that one of these 3 nerves is pinched or being compressed somewhere along the nerve route that is causing your pain.
Signs and symptoms of a pinched nerve:
- Usually unilateral, meaning only on one side
- May get worse if you turn your head
- Feeling of pins and needles in your shoulder or down to the hand
- Sharp, aching or burning pain that may radiate
- Weakness in the arm
How to help prevent further injury:
- Maintain good posture – reduce forward head posture and rounded shoulders
- Incorporate stretching and strengthening into your daily routine
- Limit repetitive movements and activities and stop activities if causing pain or irritation