Let me shortly explain my thought process behind why I need more information than just ‘’I have a shoulder pain’’ to best help you. But firstly, let’s completely set aside acute trauma injuries (fractures, dislocations, etc.) and post-surgical cases- those are massive discussions on its own. Instead, we will focus on the type of shoulder pain, discomfort, neurological issues etc. that started gradually with known or unknown mechanisms or it’s been some time after trauma/surgery that you experienced in the past.
Before we carry on, see the pic below. Shoulder area- you have 4 JOINTS around (joint is the space between bones). Around/ inside of those joints are numerous structures such as nerves, veins and arteries, muscles and connective tissues (ligaments, tendons, capsule, labrum, bursae, fibrous bands, bones, cartilage, fascia…)
Based on the assessment findings (see part 2) & before I even start thinking about specific structures (tendons, cartilage...) around/inside of these joints, I need to consider a bigger picture about what could be causing or contributing to your problem as your body is made up of different systems (musculoskeletal, endocrine, nervous...) all interacting with each other.
Auto-immune & systemic disorders, sinister pathologies (these are very rare but have to be excluded first)- for example infections, cancer, diabetes, peripheral artery disease…the list is extensive.
Referred pain (coming from somewhere else)- visceral (from organs)- e.g., danger signals from spleen can refer to shoulder, somatic (coming from other structures- example; irritation of growth plates in AC joint, we call it ''apophysitis'' in youngsters. This pain from top of the shoulder may radiate further down to the front of the shoulder, this is actually very common in many other injuries. It could also be coming from your neck (cervical spine) causing an irritation/compression to nerves that supply the shoulder area.
Let's now assume that you don't have any cervical involvement (this can sometimes even coexist with shoulder pain coming from well, shoulder itself), infection, auto-immune disorders etc.
Based on the next 3 things, I will decide what to do going forward & what could most likely be causing you problems
This is what part 2 is about. Click here
Comments