WHAT’S THAT NIGGLE IN MY SHOULDER???
Our shoulders are the most mobile joint in the body and you can think of it as a stable base for all upper limb movements, even to fine motor tasks such as playing the piano! Most of our daily activities involve upper limb use and because of this, our shoulders work hard to make all our arm movements efficient as they can be. Therefore, it can be susceptible to the occasional overuse type of injuries.
Some of us who are experiencing this sore niggle can feel:
- A constant soreness or dull ache in the shoulder
- Difficulty with overhead activities, lifting or carrying
- Pain with lowering the arm from an elevated position
- Reduced movement or being unable to reach your arm up high
- Difficulty laying on the painful shoulder
WHATS CAUSING THIS NIGGLE?
Most of shoulder pain sufferers are those who are exposed to extended periods of upper limb use (i.e. non-traumatic). This is typically seen in blue collar workers who must do sustained overhead activities or even just repetitive upper limb work. For instance, activities like hammering, sawing, lifting, painting, pick packing or even sports like volleyball, cricket and tennis can cause shoulder pain.
Office workers are also susceptible to shoulder problems as poor postures can develop over time by being hunched over at a computer or a desk. This can lead to weakness of the muscles that stabilise your shoulder and scapula which leads to increased loading down the arm.
All of this is not to say, stop doing these activities. It is important to understand that with anything, if we overload the body to a level that it is unadapted to, then it can be a potential cause for injury. Therefore, make sure you gradually introduce your body to a new activity, gradually increase the intensity of an activity, and take regular breaks if you are doing repetitive work.
COMMON POSSIBLE INJURIES:
- Rotator cuff muscle/tendon overload: The rotator cuff is a group of muscles around the shoulder that keep the shoulder joint stable with arm movements. They are always working with any arm movements and with repetitive upper limb use, they can get fatigued and injured if not given enough time to recover.
- Subacromial impingement: In simple terms, it just means that there is reduce space in the top of the shoulder (subacromial space). This can impinge (or press) on structures around that area such as the rotator cuff tendons or subacromial bursa which is a small pouch of fluid. This can lead to restrictions in movement and pain.
- Labral tears: The labrum is a piece of cartilage around the shoulder joint socket which deepens the joint and adds stability. This can be damaged through degenerative changes or traumatic incidences like a fall or carrying something heavy.
- Shoulder arthropathy: This generally means that there are some changes in the shoulder joint for example thickening of the joint capsule or reduced joint space which restrict movements in the shoulder.
HOW DO I GET RID OF IT?
- Reduce the duration and/or intensity of the activities that aggravate your shoulder pain to a level that is more tolerable.
- If you are working and it is not possible to do as mentioned above, you should take short but regular breaks if possible.
- Overtime with shoulder pain, we can develop poor movement patterns in the shoulder. Although this may not be a direct cause for pain, it can lead to increased loading in the arm which may cause fatigue and then pain. Scapular control exercises are helpful in correcting these movement patterns, but it is ideal to have it assessed and then given a specific program to you, as everyone moves differently.
- Strengthening up your rotator cuff muscles will help them cope with the load they need to work at.
- Cervical and thoracic spine mobility exercises – Improving the mobility in your neck and mid back can also be an adjunct to shoulder rehab program.