Shoulder Conditions

Types of Shoulder Condition

Types of Pain

Calcific Tendonitis

Irritation of the tendons around the shoulder can lead to calcium deposits to form within the rotator cuff tendons. This can cause a build-up of pressure and chemical irritation which leads to pain. The calcium deposit can reduce the space between the rotator cuff and the bony process above, this is worse with overhead activities. Tends to be more common in those aged 30-60 years, it does disappear completely on its own but this can take several years to resolve.

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Rotator Cuff Pain

Irritation of the rotator cuff tendon is one of the most common causes of shoulder pain. Tendinopathy is an umbrella term that covers a number of conditions that present and respond to treatment in similar ways. Often tendinopathy follows a period of overload or trauma, such as a strain or prolonged compression. Rotator cuff tendinopathy is often the correct diagnosis in misdiagnosed frozen shoulders. Tendinopathy results in the tendon becoming painful, this can either be intermittent following certain movements or loads or constant in some cases. Often there will be little pain at rest or when doing activities with a tendinopathy, but you may experience your symptoms later the same day or the next day. This is normal in tendinopathy.

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Collarbone Conditions (Acromioclavicular Joint)

The Collarbone is called the Clavicle, the joint at the end of the collar bone near the shoulder is called the Acromioclavicular joint (ACJ). Causes of ACJ pain can be either after injury (for example falling on an outstretched hand or sporting injuries) or without injury (gradual onset, often related to osteoarthritic changes).

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Shoulder Dislocation

Dislocations can be after an injury (e.g rugby tackle or car accident and is usually the first incident) or without trauma (minimal force involved e.g reaching or turning in bed). The ball and socket joint of the shoulder is made up of the upper arm bone (Humerus) and the socket (Glenoid), this joint is supported by many ligaments as well as surrounding muscles and soft tissue. The most common direction of dislocation is forwards (anterior) but can also be backwards (posterior) or inferior (downward).

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Frozen Shoulder

Also known as Adhesive Capsulitis. Commonly affects those between 50-60 years of age, females more than males and a higher risk in diabetics. Often without injury, but of gradual onset with increasing loss of movement or after trauma due to then being less mobile.

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Shoulder Osteoarthritis

Generally seen in those aged over 65 years and is less common than Osteoarthritis in other places such as the hips or knees. Can be brought on from previous shoulder surgery, previous injury (e.g. fracture), inflammatory condition (e.g. rheumatoid arthritis) or overuse injuries (e.g. weightlifters).

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Biceps Tendinopathy

The long head of biceps is approximately 9cm long and passes through a groove in the upper arm bone (Humerus) and is susceptible to injury. Biceps tendinopathy is when the long head of biceps becomes irritated leading to pain at the front of the shoulder. It is often associated with rotator cuff problems but can also occur alone.

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Rotator Cuff Tears

The rotator cuff is a group of 4 muscles which control shoulder stability and rotational movements. Rotator cuff tears are often present with no symptoms with 40-50% of those aged over 60 having a rotator cuff tear but 70% of these having no pain or symptoms. During normal aging the rotator cuff will degenerate and may then be unable to meet the demands asked of it. It is not the tear itself that causes the pain but the altered biomechanics and therefore irritation as a result. Tears can either be traumatic (from an accident) or degenerative (from normal ageing). Evidence suggests there is no difference between outcomes of surgical intervention compared to physiotherapy treatment.

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