The shoulder joint is the most mobile ball-and-socket joint in the human body. The work it does considering the complexity of all possible arm positions is unique in the locomotor system. This special ability is based on the joint being secured mainly by muscles. The ligaments of the shoulder are less pronounced. This makes the shoulder more mobile but also more prone to wear and injury than other joints. That’s why it’s particularly important to ensure shoulder health because it’s essential for an unrestricted and active life. Find out here about the anatomy of the shoulder, which conditions and injuries often occur there, and determine the causes of your shoulder pain.
Anatomy of the shoulder
The shoulder joint consists of several joints that interact to allow a high level of mobility.
The main shoulder joint connects the humerus with the glenoid cavity which is part of the shoulder blade. The joint socket, i.e. the part of the joint in which the ball-shaped counterpart of the joint rests, here the head of the humerus, is very small compared with the humerus. This makes the arm’s comprehensive movements in three planes possible because the humeral head is barely enclosed. The shoulder joint is mainly secured by the rotator cuff. It consists of muscles and tendons that allow the joint to rotate in various ways. The joint’s ligaments, on the other hand, are not very pronounced because ligaments do not allow as much mobility as muscles.
The acromioclavicular joint connects the highest point of the shoulder blade to the clavicle and supports practically all movements of the main shoulder joint with one rotational movement of the clavicle.
The sternoclavicular joint connects the shoulder girdle to the torso.
The scapulothoracic joint consists of a layer of connective tissue that ensures the shoulder blade can tilt when the arm is lifted above 90° to allow movement.
The acromion joint forms a sliding layer between the rotator cuff and the acromion and allows smooth movements of the shoulder blade across the humeral head. The large bursae within the joint act like buffers between hard and soft body parts.
Finding the causes of shoulder pain
Shoulder pain can have various causes – the shoulder joint is particularly prone because of its complex structure. Therefore, diagnosis and treatment must start with the question what kind of pain the patient is experiencing.
- Acute shoulder pain occurs suddenly: a fall or an accident is often the cause.
- Chronic shoulder pain, on the other hand, develops over a longer period. It often goes unnoticed to begin with, but then progresses all the more persistently.
Incorrect posture, excessive strain, and inactivity are often causes of chronic shoulder pain. Avoiding excessive, regular shoulder strain is particularly important in this case to keep the shoulder joint healthy and pain-free. Extensive overhead work as well as certain sports that subject the shoulder to a lot of strain are activities that should be avoided or at least limited.
When you should consult a physician in cases of shoulder pain
If one of the following three signs applies to you, you should let a physician, ideally an orthopedic specialist, have a look at your shoulder to get on top of your pain:
- Pain is sudden and intense.
- Your shoulder also hurts when it’s not subjected to strain.
- Your shoulder mobility is restricted.
The most common shoulder injuries and conditions at a glance
Your physician will help you find the causes of your shoulder pain and – depending on the indication – will create a treatment plan with you. The most common shoulder injuries and conditions include:
Shoulder dislocations happen very often. We would therefore like to provide you with in-depth information about this condition:
In cases of impingement syndrome, parts of the rotator cuff are trapped in the area between the humerus and the shoulder blade. This results in the muscles and the bursa becoming irritated in this area, followed by inflammation that increases the pain because of the constricted space. A common sign is pain that also occurs during rest. Additionally, those affected can often barely lift their arm.
Osteoarthritis of the shoulder
Osteoarthritis of the shoulder is based on wear in the joint between the shoulder and the humeral head. Pain when trying to get going in the morning and increasing problems with sideways and rotational movements of the arm are typical symptoms of osteoarthritis of the shoulder. The goal of treating osteoarthritis of the shoulder is alleviating the patient’s pain and maintaining the joint function for as long as possible while delaying surgery.
Ruptured rotator cuff
In cases of a ruptured (torn) rotator cuff, muscles or tendons are fully or partly separated. This can have different causes: on the one hand, major forces exerted on the shoulder during a sporting accident or a fall can be responsible for the injury. In older patients in particular, on the other hand, a rupture can also by caused by previous damage to tendons and muscles. In this case, even minor everyday movements are sufficient to cause a tear. Pain is usually described as twinging or piercing and can radiate all the way into the hand or neck.
How does a shoulder become dislocated?
In principle, any joint can be dislocated. However, based on its anatomy, the shoulder joint is particularly prone to dislocation.
An awkward movement is usually responsible but an external force – such as a fall or an accident – can also cause shoulder dislocation. Even a forceful downward impact is sufficient to lever the humeral head out of its socket. Furthermore, individual anatomical features of the joint and the capsular ligaments or weak muscles can facilitate a dislocation.
As soon as contact between the humeral head and the joint socket is completely lost, physicians refer to this condition as complete dislocation. If contact is only partly lost, the term will be partial dislocation. This differentiation is important for the further treatment process.
Why a dislocated shoulder can be problematic
A trained person can easily return a dislocated shoulder to its original position – at least that’s what it looks like on TV or in the movies. In reality, however, the process is quite a bit more complicated because possible associated injuries from incorrect relocation can significantly impede healing.
Major forces applied on the shoulder during relocation can, for example, lead to a part of the bony joint socket breaking off the shoulder blade when the humeral head is pushed out of the joint. The humeral head can also fracture as a result of force being exerted. X-rays are therefore indispensable to check whether bone is also involved. In these cases, the shoulder must usually be treated surgically.
Only ever get a properly trained physician to relocate your shoulder.
Procedures to restore the exact fit of the humeral head and the joint socket are crucial in preventing subsequent damage. If a step develops on one of the articular surfaces in this area, over time, mechanical rubbing can lead to damage to or destruction of the joint, i.e. osteoarthritis.
Restoring the articular surfaces as effectively as possible is essential in cases of such associated fractures. Injuries to ligaments, joint capsules, or muscles also have to heal first. For this to work, the shoulder joint usually has to be completely immobilized for a while.
The anatomical structure of the joint causes another problem: on the underneath – i.e. the connection between the humerus and the shoulder blade – the shoulder joint has a pouch consisting of connective tissue (axillary recess). This is basically a stretchy fold that allows us to lift the arm above the head. If the shoulder joint is immobilized for an extended period – for example because a bony chip has to heal – this fold can shrink, agglutinate, and thus limit freedom of movement again, even permanently in the worst case scenario. However, this minor risk should be taken so the fracture can heal properly.
Afterwards, physiotherapy is recommended as follow-up care to free the recess and ultimately restore the full range of motion in the shoulder. This kind of treatment can take several weeks but the results are usually satisfactory.
What is treatment like in cases of a dislocated shoulder?
Whether or not surgery is needed, the acute phase of treatment focuses on shoulder immobilization. Three factors are important during immobilization:
- First, the muscle cuff surrounding the shoulder joint must be trained in such a way that it can securely guide the joint and dislocation does not recur.
- Movements that could lead to recurring dislocation must be avoided.
- Later on, the mobility of the shoulder joint must be maintained or restored.
The basic rule of treatment is: stabilization first, then mobilization! It’s best to increase the restricted range of motion only when the shoulder joint has recovered sufficiently to counteract recurring dislocation
After surgery or an injury, such as a dislocated shoulder, the first thing your joint requires is total rest.
The user-friendly design of the OmoLoc makes everyday activities easier, such as physical hygiene and wound care. The flexible handling of the three arm loops also allows you to start gentle physiotherapy at an early stage.
If abduction at an angle of 15° is required as part of treatment resulting in particular shoulder relief, we recommend the OmoLoc 15. It secures the arm on a padded lateral cushion, which also serves to maintain the post-operative outcome.
Cold applications (cool packs, crushed ice) are often used to alleviate pain and inflammation. Options for preventing further injuries are also recommended: during physiotherapy, those affected will learn which movements they need to avoid initially and which muscle groups they should train. This will prevent future dislocation and stabilize the shoulder joint.