The complex shoulder

Friday, May 18th, 2018

Had my patient fallen off her conservatory roof, from the top of a ladder or fallen down a manhole cover? The bruising around the shoulder was quite major.

No, apparently, the horse had other ideas about going through the gate and had squashed my patient between its hind and the gate post! Probably half of my shoulder patients have sustained an injury during the care of their animals – be it dogs or something larger.

The shoulder is particularly susceptible to injury due to the wide range of motion this joint offers us. Because the shoulder anatomically sits between our upper back and the base of the skull, any trauma to the shoulder is widespread. Often involving the muscles of the neck, consequently producing pain in the arm. So what are the common causes of shoulder injury? Throwing a ball, being walked by the dog, raking 2 tons of gravel, loading your shoulder with too much weight, bra straps that cut into your shoulders, leading your horse and of course.. another big one.. COMPUTERS! Shoulders can become painful as a result of the ‘squirrel’ position we adopt with arms drawn forwards holding the mouse and neck craned towards the screen. Shoulder problems often appear when driving or sleeping on your side, both accompanied by pins and needles or arm pain.

I should also mention ‘adhesive capsulitis’ – commonly known as ‘Frozen shoulder’. A particularly painful condition where movement of the shoulder is extremely limited, painful and can last over a year. Corticosteroid injections are appropriate for certain shoulder conditions but these may only provide short-term pain relief.

Given the crucial role of the shoulder in our working, home and sporting life, early diagnosis and treatment of shoulder pain is key to recovery and thankfully, osteopathy offers effective relief to most common shoulder complaints.
Ian Plested