Research Assessment #8

Getting to the Source of Shoulder Pain

      So far in my research journey, I have yet to get out of my comfortable zone of knowledge of ACL injuries and physical therapy, so this week I decided to move my focus into the upper body - specifically, the shoulder. Why the shoulder? Because I have a teammate by the name of Amanda who suffered from a serious shoulder injury and was out for a year, so I decided to delve into what her physical therapy (and physical therapy for everyone with shoulder pain) looks like.
      The knee and the shoulder differ from each other in the way that the knee is a hinge joint and the shoulder is a ball and socket joint, but they both share the common synovial joints that allow for movement. Shoulder injuries can occur in any sport, the most common ones obviously being sports that require the rotation of the shoulder or a throwing motion such as baseball, football, or even swimming. However, in any sport, especially contact sports, nothing is impossible and there is always a chance that an athlete like my friend Amanda, who plays a sport where she only uses her feet and legs, can suffer from a long term upper body injury. There are a number of things that can cause injury to the shoulder; overuse, inflammation, muscle imbalances, postural issues, functional stressors, or falls. Too much of any of these events can lead to tendonitis, rotator cuff strains and tears, impingement, and even dislocation (The Iowa Clinic 1). This happens due to a lack of sufficient stabilization, which is also the leading contender of causing severe knee injuries. The most common shoulder problem, especially of athletes in those sports where throwing motions occur often, is a lack of rotator cuff strength. The rotator cuff is a collection of tendons from four separate muscles that help increase stability in the shoulder joint (The Iowa Clinic 1), and repetitive motions without rest is what causes them to weaken and cause injury. Rotator cuffs can be hurt in a single sweeping incident such as a fall, which is what happened to Amanda, or from progressive degeneration over time. And the last thing I learned about what shoulder pain was something I actually was already aware of due to my mom, who has had 3 neck surgeries and a shoulder repair surgery, is that the source of a shoulder injury and pain can actually originate from the neck. An injury or functional imbalance of the neck can actually refer to the shoulder and mimic pain (The Iowa Clinic 1). Regardless of what is causing it - the pain can and should be treated by physical therapy.
      As I read through the recommended exercises and processes for shoulder injury physical therapy, I recognized a lot of the motions from either things my mom did or Amanda had described. Typical treatment of a shoulder injury in physical therapy can include strengthening exercises, range of motion exercises, functional activities such as lifting and carrying, stretching, soft tissue manipulation, manual therapy. They are combated with shoulder isometrics (such as a shoulder abduction or internal/external rotation), resistance band strengthening (such as scapular rows, shoulder extensions, and shoulder flexions) and shoulder blade squeezes (The Iowa Clinic 2). As in any typical physical therapy recovery program, these exercises need to be completed in 2-3 sets, 3-4 times a week in order for it to be effective. My mom and Amanda are actually not great examples of this phenomenon because they were both terrible about keeping up with their home regime, which is why it took both of them so long to recover back to having full movement and functionality of their shoulders.
      I really enjoyed branching out and learning about a new injury and it’s recovery plan, although I did already have some prior background knowledge and experience with shoulder injuries. I plan to continue on with researching injuries I am increasingly unfamiliar with in hopes that gaining this knowledge now will assist me later on in my career.