Shoulder pain Physiotherapy Mechelen
The shoulder is the most mobile joint of the body with a very large range of motion. Extra mobility in a joint is often accompanied by a lack of stability, which can be a major cause of shoulder complaints. Especially with overhead athletes such as tennis players, badminton players, baseball players, ... the shoulder is a problem region. We distinguish some of the most common injuries:
Rotator cuff injury:
The rotator cuff muscles are 4 muscles with their tendons around the shoulder or humeral head. They provide stability and strength during movements of the shoulder. These muscles can be overloaded when repeating various overhead movements. Particularly in the elderly, the tendon can partially or completely rupture in the event of a sudden movement as a result of a too high load on a degenerative and/or calcified tendon. With a rotator cuff injury you typically have pain with movements above 90 °. With a rotator cuff tear, this pain is accompanied by loss of strength.
With these types of complaints, it is best to consult your doctor for a shoulder examination and determine the need for any medical imaging. An operation may be appropriate, especially with a full tear. The rehabilitation can be started after the doctor's consultation and possible surgery. During the rehabilitation we will train the muscle and tendon gradually again together with restoring the full shoulder function. Addressing the possible cause is also crucial to prevent a new injury.
Subacromial impingement:
In the case of subacromial impingement, an obstruction of a bursa and/or tendon takes place between the shoulder head (humerus head) and the shoulder top (acromion). We call this the subacromial space. This clamping occurs mainly in overhead movements and presents itself in pain at the top of the arm. In order to avoid the pain, people often avoid these movements and the shoulder becomes stiffer.
Since subacromial shoulder impingement always occurs as a symptom of another underlying cause such as: a scapular dyskinesia, an internal rotation deficit or an incorrect posture, it is important to first address the underlying cause. We obtain this by specific exercise therapy, whether or not in combination with manual therapy.
Schouder subluxation or dislocation:
Due to the great range of motion in the shoulder joint, a great deal of stability has to be ensured. We distinguish static and functional stability.
The static stability is provided by the ligaments and cartilaginous components that ensure an optimal fit of the shoulder head in the glenoid.
The functional stability is achieved by the rotator cuff muscles and the shoulder belt. When one of these is disturbed by a trauma or weakness, this results in a disturbed movement between the shoulder head and the glenoid. When the continuity between these 2 is partially disturbed we speak of a subluxation. When this is completely disturbed, we speak of a dislocation.
After a subluxation or dislocation, an examination is indicated by the doctor. Thereafter, rehabilitation with exercise therapy is necessary for restoring function and training functional stability to prevent recurrences.
Adhesive capsulitis of the schouder or ‘Frozen shoulder’:
When the shoulder joint becomes adherent together with a thickening of the joint capsule you get a loss of mobility, we call this a 'frozen shoulder'. This condition mainly occurs in people between 40 and 60 years of age after a period of immobility of the shoulder. We see an increased risk of developing a 'frozen schoulder' or adhesive capsulitis in people with diabetes.
A frozen shoulder occurs in 3 phases: first up is the 'cooling' phase where the pain is spread over the arm and becomes worse with movements. In this phase the pain is the biggest limiting factor. People are going to protect the shoulder by using it less and less, but less use of the joint causes an increase of the thickening of the capsule.
The second phase is the 'freezing' phase. The pain in the arm decreases and is mainly located at the height of the shoulder tip. During this phase, people mainly have pain when sleeping, which can cause a lack of sleep.
The third phase is described as the 'thaw phase'. The pain will decrease and the mobility will increase again. Completely going through these 3 phases can take 6 months to 2 years.
The diagnosis can be made by your doctor using an MRI scan. The rehabilitation consists of getting the shoulder capsule as flexible as possible. We do this by manual therapy in combination with exercise therapy. The faster this rehabilitation can be started, the faster and more effective it will be. So you should not wait too long to visit your doctor with these symptoms, then we can use a screening to see which exercises will make your shoulder joint pain free again. You also receive an exercise program for at home and we make the chance of injury recurrence as small as possible.
