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Shoulder Pain

The human shoulder joint

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The shoulder or glenohumeral joint is a very flexible joint that allows more movement than any other joint in the body.  It is attached to the trunk via a joint capsule and a multitude of muscles, but the head of the humerus does not sit in a true socket the way the femur or leg sits into the pelvis.   This flexibility leaves the shoulder very vulnerable to injury which may be due to trauma or overuse.  Injuries can occur to the muscle, joint, bursa, or a combination.

The shoulder joint itself may have problems due to aging, trauma, or can be caused from muscle injury or imbalance.  The joints of the shoulder consist of the meeting of the arm with the shoulder blade and trunk.  The shoulder blade also meets the collar bone and the ribs.  In this way, there are many articulations and articular surfaces to consider.  Muscles, ligaments, and the nerves of the brachial plexus coming from the neck and going to the arm all intersect here leaving endless possibilities for injury.

Muscle overuse, strain, partial, or complete tears can occur on all surfaces of the shoulder. Shoulder pain occurring along the edge of the shoulder blade close to the spine or in front of the chest  are often from pulling or pushing activities: sawing wood, shoveling, raking or vacuuming.  Repetitive strain injuries should not be under estimated especially in the case of the shoulder.  Many work activities and/or sports require repetitious pushing or pulling, sustained positions, awkward positions, vibration, or force that involve the shoulder joint and leave it vulnerable to injury.    Trauma or force can result in what many people have heard as A-C joint separation or rotator cuff tear.  These injuries will result in more pain and swelling than most muscle sprains or strains and in some cases require surgical repair.

Frozen shoulder can come on with disuse, trauma, or just gradually come on for no reason.  It is characterized by an inability to lift the arm in front or out to the side above the shoulder level.  It is often quite painful at the end of the movement and will take many months, even 1-2 years to completely resolve.  Its cause is still not fully understood.

Bursitis is an inflammation of the bursa, a fluid filled sack under the acromion.  The acromion is the part of the scapula (shoulder blade) on the top of the glenohumeral joint.  The bursa may become inflamed with any type of repetitive activity or direct trauma to the joint.

Mary Boyd, MS, PT is the owner of Mountain View Physical Therapy and a member of the Sandpoint Wellness Council.  She can be reached for more questions about shoulder pain at 290-5575 or on the web at

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