Having a tough time solving your shoulder pain? It could be the rotator cuff. Maybe it’s the shoulder joint itself? It could also have nothing to do with the shoulder at all. Hmmm.
Here’s how to know when shoulder pain is not a shoulder problem, what the real culprit could be and how to start fixing it.
The shoulder joint is formed where the humerus (upper arm bone) fits into the scapula (shoulder blade), like a ball and socket.
The shoulder has several other important structures as well:
- The rotator cuff is a collection of muscles and tendons that surround the shoulder.
- The bursa is a small sac of fluid that cushions and protects the tendons of the rotator cuff.
- The labrum is a cartilaginous cup for the ball-like head of the humerus to fit into.
Intimately connected to the shoulder are the structures of the neck. The nerves that exit between the cervical vertebra feed and receive input from many of the tissues and structures in and around the shoulder area.
Needless to say, the shoulder is one of the most complex joints in the body.
To understand how to solve a problem that is eliciting pain, it’s necessary to understand (somewhat) pain itself.
When it comes to pain, it sure feels like pain is a problem… but pain is actually a subjective experience, it’s a symptom, a signal.
Such as the case in a heart attack.
Damaged heart tissue from a myocardial infarction leads to the pain we often associate with the condition. However, it’s common knowledge that an intervention aiming only to reduce pain will not solve the problem that lead to it.
To make matters more complicated, the site of damage is rarely where pain is perceived. This is known as referred pain.
WHEN SHOULDER PAIN IS A SHOULDER PROBLEM
There are times when the main source of shoulder pain is primarily a shoulder problem.
Most often the rotator cuff (tendons and muscles that stabilize the joint) develops wear and tear with age and abuse, making it more susceptible to injury.
Some typical signs include:
- Pain in the shoulder itself or on the outside of your upper arm.
- Dull and aching pain.
- Pain occurs when you reach overhead or behind your back, or when lifting.
- Pain radiates into the upper arm, but not past the elbow.
- Persists at night.
- Improves when you rest your arm.
WHEN SHOULDER PAIN IS NOT A SHOULDER PROBLEM
More often than not, a persistent shoulder problem that is not recovering through rehabilitation of the structures around the shoulder area or with rest, is in part or in whole, a neck problem!
Some of the more likely signs are:
- Pain radiates to your shoulder blade, or close to or on the side of your neck.
- Electric-like, stabbing, burning or tingling pain.
- Radiates down past your elbow or even into your hand.
- Persists at rest.
- Radiates down your arm when you extend or twist your neck.
- Is relieved when you support your neck.
WHAT TO DO ABOUT IT
Diagnosing shoulder pain and uncovering the contributing factors is difficult for even the most experienced clinician.
Unless a trauma or fall is the obvious cause, a problem within the shoulder itself is much less than common than one would expect.
In looking to the neck as one potential factor, a comprehensive assessment will typically show:
- A structural distortion and rounding of the thoracic spine (mid back) that causes a forward tilt of the shoulder blade
- An Anterior Spinal Distortion of the neck contributing to the tightness of the musculature around the shoulder blades.
- Irritation and increased sensitivity of the neck nerves that provide sensation to the shoulder joint and power on the muscles of the shoulder.
- Reduced movement of the shoulder blade placing additional movement strain on the shoulder joint.
- Immobility of the lower cervical vertebra.
- Decrease grip strength unilaterally.
When a clearer picture of a shoulder problem comes to light and it includes a contribution from the cervical spine, the best solution to recovery is a multi-pronged approach.
- Neruro-Structural Restoration
- Cervical, Thoracic & Scapular Corrective Exercises
- Soft Tissue Therapy
- Shoulder Stabilization Training
Whether it’s chronic pain in the shoulder, neck or even both… it’s best to see an expert as soon as possible.
Without addressing the real problem, you run the risk of ongoing deterioration and negatively impacting other body parts and functions you may never have thought could be related.
Have you ever had a shoulder problem that was really a neck problem? What did you do about it?
Je, una wakati mgumu wa kutatua maumivu yako ya bega? Inaweza kuwa cuff rotator. Labda ni kiungo cha bega yenyewe? Pia haiwezi kuwa na uhusiano wowote na bega hata kidogo. Hm. Hm. Hapa ni jinsi ya kujua wakati maumivu ya bega si tatizo bega, nini mhalifu halisi inaweza kuwa na jinsi ya kuanza kurekebisha ni. Kiungo cha bega hufanyizwa mahali ambapo mfupa wa mkono wa juu (humerus) huingia kwenye scapula (blade ya bega), kama mpira na soketi. Bega ina miundo mingine kadhaa muhimu pia: - Rotator cuff ni mkusanyiko wa misuli na tendons kwamba kuzunguka bega. - Bursa ni mfuko mdogo wa umajimaji ambao hufunika na kulinda tendons za rotator cuff. - Labrum ni kikombe cartilaginous kwa kichwa mpira-kama ya humerus kufaa katika. Sehemu ya shingo imeunganishwa kwa ukaribu na bega. Mishipa ya neva inayotoka kati ya uti wa mgongo huchukua habari kutoka kwa tishu na miundo mingi ndani na karibu na eneo la bega. Bila shaka, bega ni mojawapo ya viungo tata zaidi mwilini. Ili kuelewa jinsi ya kutatua tatizo ambalo husababisha maumivu, ni muhimu kuelewa (kwa kiasi fulani) maumivu yenyewe. Linapokuja suala la maumivu, ni hakika anahisi kama maumivu ni tatizo... lakini maumivu ni kweli uzoefu subjective, ni dalili, ishara. Kama ilivyo katika kisa cha mshtuko wa moyo. Uharibifu wa tishu za moyo kutokana na mshtuko wa moyo husababisha maumivu ambayo mara nyingi tunahusianisha na hali hiyo. Hata hivyo, ni maarifa ya kawaida kwamba uingiliaji lengo tu kupunguza maumivu si kutatua tatizo kwamba kusababisha yake. Jambo linalofanya mambo yawe magumu zaidi ni kwamba mara chache mahali ambapo madhara yametokea ndipo maumivu yanapoonekana. Hii inajulikana kama maumivu yaliyoelekezwa. Wakati mgongo mgongo ni tatizo la mabega, kuna wakati ambapo chanzo kikuu cha maumivu ya mabega ni hasa tatizo la mabega. Mara nyingi, kiuno cha rotator (mchwa na misuli inayodumisha kiungo) huchakaa na kuharibika kwa sababu ya uzee na matumizi mabaya, na hivyo kuathiri sana. Baadhi ya dalili za kawaida ni pamoja na: - Maumivu katika bega yenyewe au nje ya mkono wako wa juu. - Maumivu yasiyo na hisia. - Maumivu hutokea unapofikia juu ya kichwa chako au nyuma ya mgongo wako, au unapoinua. - Maumivu huenea kwenye mkono wa juu, lakini si zaidi ya kiwiko. - Inaendelea usiku. - Inaboresha unapopumzika mkono wako. Wakati maumivu ya bega si tatizo la bega, mara nyingi zaidi kuliko si, tatizo la bega la kudumu ambalo haliponywi kwa kurekebisha miundo ya karibu na eneo la bega au kwa kupumzika, ni sehemu au kwa ujumla, tatizo la shingo! Baadhi ya dalili zinazowezekana zaidi ni: - Maumivu huenea kwenye bega lako, au karibu na au upande wa shingo yako. - Maumivu kama ya umeme, yenye kuchoma, yenye kuchoma au yenye kuchochea. - Inatoka chini zaidi ya kiwiko chako au hata ndani ya mkono wako. - Anaendelea kupumzika. - Inatoa mionzi chini ya mkono wako unapofungua au kugeuza shingo yako. - Ni kuachiliwa wakati wewe kusaidia shingo yako. Ugonjwa wa bega na kugundua sababu za maumivu ni vigumu hata kwa daktari mwenye uzoefu zaidi. Kama si ajali au kuanguka ni sababu dhahiri, tatizo ndani ya bega yenyewe ni chini ya kawaida kuliko mtu angetarajia. Kwa kuzingatia shingo kama sababu moja ya uwezekano, tathmini ya kina kwa kawaida itaonyesha: - Uharibifu wa muundo na mzunguko wa uti wa mgongo wa kifua (kati ya nyuma) ambayo husababisha mwinuko wa mbele wa bega - Uharibifu wa shingo ya mbele ya shingo unaochangia ugumu wa misuli karibu na bega. - Kuchochea na kuongezeka kwa unyeti wa neva za shingo ambazo hutoa hisia kwa pamoja ya bega na nguvu kwenye misuli ya bega. - Kupunguzwa kwa mwendo wa kiwiko cha bega na kuweka mzigo wa ziada wa mwendo kwenye kiungo cha bega. - Usiwe na uwezo wa kusonga wa uti wa mgongo wa chini. - Kupunguza nguvu ya kukamata upande mmoja. Wakati picha ya wazi ya tatizo la bega inakuja na ni pamoja na mchango kutoka uti wa mgongo wa shingo, suluhisho bora kwa ajili ya uponyaji ni mbinu ya pande nyingi. - Neruro-Structural Restoration - Cervical, Thoracic & Scapular Corrective Exercises - Soft Tissue Therapy - Shoulder Stabilization Training Ikiwa ni maumivu ya kudumu kwenye bega, shingo au hata zote mbili... ni bora kuona mtaalam haraka iwezekanavyo. Bila kushughulikia tatizo halisi, wewe kukimbia hatari ya kuendelea uharibifu na athari hasi sehemu nyingine za mwili na kazi unaweza kamwe kuwa walidhani inaweza kuwa kuhusiana. Je, umewahi kuwa na tatizo la bega ambalo kwa kweli lilikuwa tatizo la shingo? Ulifanya nini kuhusu hilo?