Shoulder pain is a very common complaint, and ranges from debilitating to merely inconvenient and annoying.
The human shoulder is a marvel in the animal kingdom and may be arguably one of the most important pieces that allowed humans rise to dominance within the animal kingdom. It allows us to reach over our head for climbing, hanging, or picking things, to weight bear when we need to crawl low to the ground , and possibly the most important to our evolution as a hunter, to throw projectiles like spears and rocks (and today footballs and baseballs). The amazing variety of this joint comes with some engineering compromises, which lead to some very common and specific injuries. Many of these can be handled conservatively, and a small percentage will require surgery. Finding a doctor who understands shoulders and has experience working with them is critical to getting a good outcome.
The “shoulder” joint actually has 3 components:
• The Glenohumoral (GH) joint is a ball and socket, with shallow socket for maximum range of motion but vulnerable to excess mobility. Common problems with this joint are capsule issues, frozen shoulder, bursitis, tendinitis, tendinosis, and rotator cuff issues. This is usually the joint people mean when they say shoulder pain and also the joint we refer to in a “dislocated shoulder.” This is also the most common joint to require surgical intervention.
• The Acromioclavicular joint, connects the scapula (shoulder blade) and clavicle joint at the acromion process and the clavicle. It is also frequently injured, usually a little less debilitating than a GH joint injury. This is usually the joint people mean when they say someone has a “separated shoulder.”
• The Sternoclavicular joint is less commonly the main problem, and thus gets overlooked even though it can often be involved in shoulder dysfunction. Chiropractors who are experienced with extremities are often very helpful with correcting this joint and getting a more complete resolution of shoulder pain and dysfunction.
• The Scapula, or shoulder blade, is not a bone to bone joint but is also very important in normal shoulder function. It “floats” along the ribcage/thorax and is guided by muscles, tendons and ligaments. This is commonly a focus of treatment with physical therapy.
