ShoulderProblems

The shoulder is a very mobile ball and socket joint that enables us to put our arms through a wide range of movements. Because of this versatility, and frequent use, the joint is prone to a lot of injuries and ailments.

Surrounding the ball and socket is a sleeve of muscles and tendons called the rotator cuff. This stabilises and moves the joint. The rotator cuff is easily injured by over use giving rise to various conditions that cause pain and reduced movement. The two commonest problems are called Painful Arc and Frozen Shoulder.

Painful Arc

This results from the muscles of the Rotator Cuff catching on the underside of the bone at the shoulder tip (the Acromium). The resulting inflammation causes pain when the arm is lifted outwards from the side of the body. Repetitive overhead arm movement is the usual cause and it is often something as innocent, for example, as a weekend painting the ceiling. To relieve the condition you should avoid any activities that have caused the pain. You should, though, do the flexibility exercise mentioned below and follow the other general measures listed.

Frozen Shoulder.

When the whole of the Rotator Cuff becomes inflamed all movements are painful and reduced – sometimes to the extent where, even with help, you can only move the arm slightly. Hence the title “Frozen Shoulder”. The condition has nothing to do with the joint being cold and, in fact, ice treatments (see below) are very helpful. Any form of injury or disuse (e.g. after a stroke) can give rise to a Frozen Shoulder. Even without specific treatment improvement will occur but it can take up to two years. It is important to maintain movement and the general measures below will help.

General Measures

· Inflammation is often present so try a course of anti-inflammatories, e.g. Ibuprofen 400mg three times a day with food. The exception would be if you have had a stomach or duodenal ulcer, suffer from asthma or get regular indigestion then you should avoid such medication.

· At the same time you can also take a regular dose of painkiller, e.g. Paracetamol one or two tablets four times a day.

· Ice packs can be applied every 2-3 hours. To make an ice pack take some ice, or frozen peas, and wrap in a cold damp cloth. Put this on the shoulder and leave for 10-15 minutes.

· Whatever the condition maintaining some degree of movement and flexibility is important. The following simple so called “Pendulum Exercises” will help:

o Starting from a standing position put one foot slightly in front of the other and then lean forward a little so the affected arm hangs in front and to the side of you. To keep stable hold onto, for example, a chair with the other hand.

o Let the arm hang loosely and relaxed.

o Swing the arm gently backwards and forwards – a bit like an exaggerated form of arm swing when walking.

o Gradually increase the amplitude of the swings.

o Do this for 1-2 minutes and then rest.

o After this, again with the arm hanging loosely as above, start moving in small circles. Gradually increase the size of the circles.

o Make circles in one direction for 1minute, rest, and then go in the other direction for a further minute.

Repeat the whole process 3-4 times a day.