If you’ve ever had recurrent shoulder pain there may have been many times that you’ve considered just going ahead and cutting the dang thing off. Self-identifying what is causing the pain is difficult; you may not be able to tell what exactly is causing it, you just know It needs to stop. Do not put off getting a professional diagnosis. Consult an orthopedic physician that specializes in shoulders who can accurately diagnose and treat injuries often without surgery.
Most of us can’t say with full certainty which set of ligaments or the anatomically correct term for which part of the shoulder is causing our lives to be a painful purgatory. Understanding the shoulder is a great first step towards understanding your pain. And knowing why the parts that are hurt got hurt is a great way to begin preventative treatment.
Anatomy of the Shoulder
Quite simply, the shoulder is composed of bones, soft tissues, ligaments, muscles, tendons, nerves, and blood vessels. Here’s the major function of each of these components:
Bones: The shoulder is made of three bones that fit together. The humerus and scapula form the main ball joint of your shoulder. The clavicle exists to provide support and stability as it serves as an attachment site for most of the muscles and ligaments in the system. The clavicle also serves as an armoured layer under which blood vessels and nerves are protected as they run from the spinal column down through the arms.
Tissues: The shoulder utilizes soft tissues. At the ends of the humerus, there is smooth cartilage that insulates, absorbs blows, and allows for smooth unrestricted sliding of the bones against each other. Smooth tissues are also utilized around the main joint, glenoid cavity, called the glenoid labrum to increase the stability and cohesivity of the functioning of the shoulder joint.
Ligaments: Ligaments are thick fibrous bands that connect bones to each other. Glenohumeral ligaments are a set of three ligaments that connect the humerus to the glenoid cavity. They provide stability and help prevent dislocation. The Coraco-acromial ligament attaches at two sites of the clavicle. Other ligaments provide additional stability and mobility functions.
Muscles: There are four main muscles. A rotator cuff is a group of muscles that surrounds the main joint and accounts for the stability and maneuverability of the shoulder. The deltoid is the strongest muscle of the grouping and accounts for much of the strength of the shoulder.
Nerves: The nerves of the shoulder have the same function as any other area according to motor and sensory. The shoulder is innervated with motor and sensory neurons to control movement and perceive damage. There is also a neural branch that extends under the shoulder blade and down the arms to control motor and sensory processes.
Blood vessels: The blood vessels of the shoulder function as would a large interstate. There are main superhighways that run underneath the collar bone and down the arms. Along the way, there are many exits that further branch until they are so small that they surround each and every cell so that cellular respiration and the exchange of gasses (CO₂ and O₂) can occur throughout the arm and the entirety of the shoulder.
Types of Shoulder Injury
Now that we understand the parts of the shoulder and their function, making sense of the injuries that can occur might be a little easier. Some of the most common conditions include:
Shoulder Dislocation: This is a condition that generally occurs as a dislocation of the humerus from the glenoid cavity in the forward direction, however, it can occur backward or downwards. This will cause pain and instability or greatly reduce functionality. It is possible that there will be tears in the tendons and ligaments or nerve damage. Generally, this is an easily diagnosable (requires an X Ray) and easily treatable condition. Usually only requires to be reset, several weeks in a sling with ice often before engaging in physical therapy to regain mobility.
Shoulder Impingement: This is a condition of inflamed tendons of the shoulder joint. It is generally caused by repeated overhead movement. This issue may persist during activity and inactivity resulting in sometimes severe pain. Diagnosis is sometimes difficult and may require MRI or X ray scans to identify injury and inflammation. Treatment can vary. Initially, options such as extended rest, ice, and anti-inflammatory drugs are explored. If this does not take effect, steroidal injections and physical therapy may be used. If the initial diagnosis indicates that the rotator cuff is torn and there are bony spurs arthroscopic surgery will be suggested to remove said spurs.
Acromioclavicular Joint Arthritis: This condition is generally caused by general wear on the cartilage of the acromioclavicular joint due to repeated shoulder-level/over-head activities or age. This can be identified by X rays (via increased bone density, joint space loss or the presence of bony spurs) or MRI scans (via fluid accumulation or cartilage destruction). This can be moderated by limiting activities and pain reduction methods such as pain killers, steroidal injections, or anti-inflammatory medications. Surgery is a last resort and generally includes the removal of bone, bony spurs, and the repair or any ligaments or tendons that may be damaged.
Now that we know a little about some of the possible ailments we’re facing, it might be hard to say that we understand the importance of trying the natural methods first. If we know that surgery should fix it, why is it important to try the natural methods first? As Dr. Peter Howard, a Florida shoulder surgeon would say, it is always recommended to try and assist the powerful natural healing processes of our own bodies before permanently altering anything. Surgery inherently holds some risk and it’s likely that the human body will surprisingly recover on its own accord with proper guidance.