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Rotator cuff syndrome
Shoulder pain is usually caused by what is known as rotator cuff syndrome, which occurs when the tendons in the rotator cuff of the shoulder blade get pinched.
Of all the joints in the body, the shoulder has the greatest mobility. It consists of four joints. The two largest of these are formed by the attachment between the upper arm bone and the shoulder blade; and the attachment between the shoulder blade, and the chest wall.
The attachment between the upper arm bone and the shoulder blade consists of a small socket and a large head. This combination makes it possible to move the arm in many different directions. However, from a structural point of view, the flexibility of this ball and socket joint also put it at risk of becoming destabilized. To compensate, there are several anatomical structures present which help to stabilize the shoulder. These include: the joint capsule, the ligament, the diaphragm and the rotator cuff itself.
The rotator cuff consists of four smaller muscles, which form a series of ‘cuffs’ around the head of the upper arm bone. The most important function of the rotator cuff is to stabilize the shoulder joint during movement. However, the shoulder blade needs to be positioned and move correctly for the shoulder to function normally.
The four muscles of the rotator cuff protrude from the shoulder blade, slide under a bone ceiling and attach to the upper arm. Different conditions can cause the rotator cuff to be clamped under the bone ceiling, which can result in the tendons becoming pinched.
Damage to the rotator cuff is often the result of performing intense, repetitive or unusual arm movements above shoulder height e.g. when you are painting a ceiling or playing badminton. With age, these tendons weaken naturally, increasing the risk of injury.
When the shoulder is overloaded, the tendon becomes sore and swollen. This is a sign of inflammation. The tendon can also become trapped under the bone ceiling, which results in even greater pressure being put on the tendon. In this case, the shoulder needs relief and controlled rehabilitation exercises.
The shoulder must, first and foremost, be relieved of all kinds of painful loads, especially when using the shoulder in its outer positions.
Start by performing controlled exercises that consist of small movements. This will typically be in the form of low resistance movement exercises, which stimulate the shoulder and help it return to normal functionality.
As rehabilitation progresses, you will need to put greater focus on the balance around the shoulder as well as the strength and stability of the muscles that control the shoulder blade and the small rotator cuff tendons.
Strength exercises are an excellent way to prepare you to cope with the types of arm loads and pressures encountered in everyday life. These help the arm and shoulder handle loads and perform normal activities that involve lifting the arm above shoulder height. The best way to strengthen this area of the body is high resistance strength training.