In this blog, we will briefly outline the functional anatomy of the shoulder and touch on some common causes of shoulder pain and why you may need shoulder physiotherapy.
The shoulder is a complex structure made up of 4 separate joints and many muscles and ligaments. For full function to occur the shoulder needs to perform large ranges of motion while remaining strong and stable.
This is made possible by well balanced structures which can be classified as static or dynamic stabilisers. The static stabilisers include the boney articulations, the ligaments and the joint capsules of the glenohumeral joint, acromioclavicular and sternoclavicular joints. To allow for greater movements, even in a healthy shoulder, these need to be quite lax. To make up for this laxity, we rely greatly on our dynamic stabilisers, the muscles surrounding the shoulder.
These include the rotator cuff muscles, that act directly on the glenohumeral joint, as well as those that act on the scapulo-thoracic joint, but all must work in coordination for good shoulder function.
The muscles of the rotator cuff include the supraspinatus, infraspinatus, teres minor and subscapularis. As well as moving and positioning the arm, they contract synergistically to centralise the humeral head in the glenoid socket throughout the shoulder’s large ranges of motion.
When the shoulder is balanced and moving healthily it can be referred to as having good scapulohumeral rhythm. This relies, in part on scapular stabilisers which include serratus anterior, trapezius, pectoralis minor and levator scapulae.Their role is to position the scapula and therefore the glenoid socket in order to allow the humerus it’s full movement.
As the rotator cuff muscles arise from the scapula, a stable well positioned scapular is also important to provide a base for these muscles to function effectively from. If any of these structures are not working effectively it can have an impact on shoulder function and lead to pain. Physiotherapists can work on these structures to help you to restore the balance and improve shoulder pain and function.
Pain related to poor scapulohumeral rhythm can sometimes be referred to a rotator cuff related pain, we have another video in this series which describes rotator cuff related pain. Other causes of shoulder pain include:
- Adhesive capsulitis
- Referred pain
- Long-head of biceps injuries
- Acromioclavicular or sternoclavicular joint injuries
- Shoulder instability
- Nerve injuries or compressions
If you are experiencing shoulder issues and would like to have your shoulder examined by one of our fully qualified shoulder physiotherapists, please call us at Melbourne Hand Therapy today (03) 9899 8490 or leave an enquiry and we will get back to you as soon as possible.
