Shoulder Pain

To fully understand what causes shoulder pain, let’s start from the beginning and talk about what makes up the shoulder joint. The shoulder joint is a ball and socket joint, think of it as a golf ball sitting on a golf tee. It allows for a large amount of motion, so supporting muscles and tendons are a critical support system for optimum functionality.The humerus, scapula, and the clavicle make up the shoulder joint. Soft tissue structures such as ligaments, tendons, muscles, and the labrum support the joint. When all these structures work together, your shoulder functions perfectly. So what happens when certain motions are painful? Or when a routine or easy task becomes difficult because of pain?

Shoulder Pain Causes

  • Rotator cuff tear
    • Can be caused by an acute injury or degenerative changes.
    • Tears can be partial or a full thickness depending on the extent of the injury. Tears can also occur in the biceps tendon.
    • Symptoms include pain with motion or inability to lift the shoulder or weakness with certain activities.
  • Labral tear
    • The labrum acts as a stabilizer for the shoulder. An injury to the labrum can be caused by an acute injury or from changes over time.
    • There are several different types of tears which include a SLAP tear, Bankart tear or posterior labral tear.
    • Symptoms include achiness, instability, pain with certain motions, or catching and popping sensation.
  • Fractures
    • A fracture is a break in the bone. It takes a lot of force to break a healthy bone and typically this type of injury is seen in traumatic accidents. However fracture can be seen in elderly patient from a fall from standing height.
    • Symptoms include pain with movement, swelling, bruising and an obvious deformity.
  • Instability
    • Instability is when the head of the humerus is forced or moves out of place on the glenoid.
    • Sometimes this is a result of an injury such as a dislocation or subluxation but instability can also be caused by over use and stretching of the supporting soft tissue structures over time.
    • Repeated dislocations and subluxation also causes stretching of these structures. 
  • Some other causes of shoulder pain include tendonitis, impingement, arthritis and bursitis.

Treatments for shoulder pain include medication, physical therapy and/or surgery. Depending on the type and extent of injury surgery may be required in order to reduce or eliminate pain. Consulting with your orthopedic doctor, physician assistant or athletic trainer can help you determine the cause and formulate a treatment plan that is best for your shoulder pain. Sometimes test such as x-rays, MRI, CT or EMG are needed to determine the full extent of the injury. Your orthopedic doctor will be able to help in determine if those are needed and order the test.

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Kathryne J. Stabile, M.D., M.S.

Sports Medicine, Shoulder

Michael W. Gish, M.D.

Sports Medicine
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