Conditions that cause it and risk factors for these conditions
Shoulder Impingement, this is very much an umbrella term often used by clinicians to say shoulder pain. This pain can be caused by an acute injury or a chronic condition which both appear to develop a biomechanical element. Whether this be an acute injury to muscles, tendons, Fractures or Dislocations. If these are not rehabbed and treated appropriately there is a risk of developing muscle imbalance, poor control, reduced proprioception and reduced postural control. This pain usually appears slowly and develops over time, even after an acute injury once the initial pain has resolved.
Frozen Shoulder, there is still limited information as to the initial cause of this problem. Frozen shoulder is the loss of movement due to severe pain, it then develops into a stiff shoulder with loss of movement with less pain. Finally it “thaws” in which there is a slow increase the movement at the shoulder joint. Your risk is increased if you are diabetic and if you have had frozen shoulder on one side there is an increased chance of reoccurrence on the other side. However if you have had Frozen Shoulder there is no evidence of it re occurring in the same shoulder.
Osteoarthritis of the shoulder joint, this appears very similar to frozen shoulder, however it is often more stiffness than pain that limits the movement. The risk for Osteoarthritis of the shoulder is similar to risks at other joints such as previous injuries, surgery and genetics.
Acute injuries- Dislocations, Fractures and Tendon ruptures. Risk factors for all of these are contact sports however any trauma, slips, trips and falls all will increase a risk. However you can get Attrition ruptures of tendons when they rupture with normal use, this is associated with age, previous injuries, and Steroid use.
What are the treatment options?
For shoulder impingement it is important to work to correct this as early as possible as the longer it goes on for the more difficult it can be to correct. All the effective treatments and recommended treatments involve rehab exercises especially with the support of a physiotherapist, other treatments include NSAIDs, steroid injection and surgery, all of these are in conjunction with physiotherapy post the initial treatment. There is even some recent research that 5 years on from initial treatment start physiotherapy alone is as good as if not better than surgery and then treatment.
For a Frozen Shoulder treatment involves maintaining movement as much as possible, this can be with manual therapies and exercise, this is often alongside suitable painkillers to allow the effective treatment. There are multiple procedures that can help increase movement with this condition however there is limited research as to if these procedures are beneficial in reducing the painful period where the movement is lost. Even once movement has returned it is important to rehab properly and training the correct muscles as there is a significant risk of developing shoulder impingement pains following suffering from a frozen shoulder.
Osteoarthritis of the shoulder is generally treated with exercises to encourage movement and maintain strength, there are options for joint replacement. However, these will only be done to increase comfort as with other joint replacements, some movement is generally lost when completing the replacement. Following the replacement a course of physiotherapy is required to ensure the best outcome is possible to maintain a much function as possible.
Following an injury to the shoulder it is important for it to be assessed, depending upon our age, the type of injury and the reoccurrence of injury will have a big effect on treatment options available for you. Some injuries will require surgery, some will require resting in a sling. Whether surgery is needed or not physiotherapy can help improve you recover after an injury both prehab before potential surgery and rehabbing after surgery or the injury. All of this can help significantly reduce your risk of reinjury.
How Physiotherapy can help?
As you can see from the information above, Physiotherapy is a vital part of recovery from shoulder injuries. If you have any shoulder injuries get booked in before they develop into anything more sinister.
Comments