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The shoulder is a complex joint which needs to allow for the large range of movement the arm enjoys, whilst providing enough strength and stability to allow humans to push, pull and carry weight’s exceeding their own body weight. Whilst the joint allows a greater range of movement than any other in the body this flexibility means that a shoulder injury is fairly common.
The shoulder is made up of three bones; the clavicle, scapula and humerus. What we would normally refer to as the shoulder joint is where the head of the humerus (upper arm) attaches to the scapula (shoulder blade). The rounded head of the humerus forms a ‘ball and socket joint’ with the scapula. This allows for rotation at the joint as well as hinge like movement of the arm up and away from the body. The shoulder is kept stable by muscles and tendons which are collectively known as the rotator cuff. Despite the actions of the muscles, tendons and ligaments of the shoulder to provide stability, the large range of motion means the joint is more susceptible to dislocations and other painful conditions when compared to other joints in the human body.
Some of the more common causes of a shoulder injury include:
Rotator Cuff Tears – The rotator cuff consists of four muscles and their tendons which work to keep the round head of the upper arm in the socket of the shoulder blade. In addition to this the muscles connect the arm and shoulder blade and contract to cause movement at the joint. Damage to any of these muscles will cause pain, especially when lifting the arm, and weakness in the arm.
Glenohumeral Dislocation – The ball and socket joint where the head of the humerus meets the scapula is called the glenohumeral joint. When the humerus becomes detached from the socket, either fully or partially this is named glenohumeral dislocation. Whether a partial or full, any dislocation will cause pain and instability in the shoulder. Other symptoms include swelling, bruising and tenderness. The dislocation may also damage the nerves and tendons surrounding the joint.
Impingement Syndrome – When the rotator cuff tendons and the bursa surrounding them become inflamed they can pinch between the bones of the shoulder and cause pain. The tendons of the rotator cuff connect the muscles to the bones of the shoulder, surrounding these tendons are bursa which help the tendons to glide freely over the bone. When you raise your arm the space between the shoulder bone (acromion) and the rotator cuff muscles narrows. This can rub on the tendons and bursa causing them to inflame. As they become inflamed the space becomes even more limited and they rub more and more.