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Shoulder

The shoulder is composed of a number of layers, such as:

  • Bones: The shoulder consists of the clavicle (collarbone), scapula (shoulder blade), and humerus (upper arm bone).
  • Joints: Enable movement through:
    • Sternoclavicular joint – the part where the clavicle and the sternum meet.
    • Acromioclavicular (AC) joint – the area at which the clavicle connects to the acromion.
    • Shoulder (glenohumeral) joint – a ball-and-socket joint allowing forward, backward, and circular movement.
  • Ligaments: These strong, flexible, shiny bands of fibrous tissue connect bones, cartilage, and joints, including:
    • Joint capsule – ligaments linking the humerus to the shoulder socket on the scapula, stabilising the joint and preventing dislocation.
    • Ligaments attaching the clavicle and the acromion.
    • Ligaments connecting the clavicle to the scapula via the coracoid process.
  • Acromion: The highest point or roof of the shoulder that is formed by a section of the scapula.
  • Tendons: Tough tissue cords linking muscles to bones. The rotator cuff tendons attach the deepest muscle layer to the humerus.
  • Muscles: Support and enable shoulder rotation in multiple directions.
  • Bursa: A fluid-filled sac between two moving surfaces, positioned between the rotator cuff muscles and the outer layer of larger muscles.
  • Rotator cuff: A set of tendons and muscles (rotator cuff) that keep the ball of the glenohumeral joint secured over the humerus.

Shoulder pain may occur in one spot or radiate to surrounding areas, including the arm.

Causes of Shoulder Problems

The shoulder, being the body’s most mobile joint, is also highly unstable due to its wide range of movements. The upper arm’s ball is larger compared to the shoulder socket, thus making it prone to injury. Soft tissues—including tendons, muscles and ligaments—help support the joint but are vulnerable to stress, overuse, or lack of use.

Additionally, degenerative conditions and other illnesses can contribute to shoulder issues, sometimes causing pain that spreads through nerves toward the shoulder.

Types of Shoulder Problems

Several prevalent shoulder issues include:

  • Dislocation – The shoulder joint is the commonly dislocated main joint. A strong force can push the upper arm bone (humerus) out of its socket (glenoid).
  • Separation – Occurs when ligaments connecting the collarbone (clavicle) to the shoulder blade (scapula) tear partially or completely, often due to a fall or direct impact.
  • Bursitis – Tenderness of the bursa sacs, frequently caused by tendonitis or impingement syndrome.
  • Impingement syndrome – Results from excessive pressure or rubbing of the shoulder blade against the rotator cuff. It can cause pain, bursa inflammation, rotator cuff tendon swelling or calcium build-up in tendons, sometimes leading to a rotator cuff tear.
  • Tendinosis – Degeneration of the rotator cuff or biceps tendon due to pinching by nearby structures. It can range from mild inflammation to significant tendon involvement. Thickened and inflamed rotator cuff tendon can be trapped beneath the acromion.
  • Rotator cuff tear – Damage or tear to one or more rotator cuff tendons due to aging, overuse, falls, or collisions.
  • Adhesive capsulitis (frozen shoulder) – A condition that severely limits movement, often triggered by injury and pain-related inactivity. Inflammation and adhesions develop between joint surfaces, and the absence of synovial fluid further restricts motion.
  • Fracture – A partial or complete bone break that is mostly caused by trauma or impact.

Diagnosing Shoulder Problems

Diagnosing shoulder issues involves a medical history review and a physical exam to assess pain, range of motion, and joint stability. Additional tests may comprise:

  • X-ray – Uses electromagnetic beams to capture images of inner bones, tissues or organs.
  • MRI (magnetic resonance imaging) – Uses magnets, radio waves, and a computer to create detailed pictures of muscles and ligaments.
  • CT (computed tomography) scan – Combines X-rays and computer imaging so as to provide cross-sectional views of muscles, bones, and organs. This provides more clear details compared to the standard X-rays.
  • EMG (electromyogram) – Assesses nerve and muscle function.
  • Ultrasound – Employs high-frequency sound waves in order to visualise internal structures.
  • Laboratory tests – Identify underlying conditions that may contribute to shoulder pain.
  • Arthroscopy – A minimally invasive procedure using a small, illuminated tube inserted through a tiny incision to examine joint surfaces, detect tumours and diseases and assess inflammation and pain causes.

Treatment of Shoulder Problems

The appropriate treatment depends on factors such as age, health, medical history, condition severity, treatment tolerance, expected recovery, and personal preferences. Possible treatment options include:

  • Activity adjustment
  • Resting
  • Medications
  • Physical therapy
  • Surgery

Bottom Line

The shoulder is a complex body part made up of various layers. It is also prone to a broad range of problems that can range from mild discomfort to severe conditions requiring medical intervention. Early diagnosis and proper treatment are helpful in restoring function and preventing more complications.

Book an appointment today or talk to our professionals for expert advice on overall shoulder health and regaining strength.