Anatomy, Pathology & Treatment of the Shoulder Joint

Anatomy

The shoulder is a ball and socket joint, referred to in medical terms as the gleno-humeral joint. It is a very mobile joint and relies upon a vast array of muscles to help stabilise it and allow a large range of motion. It is closely linked with the neck and shoulder blade (scapula), and the acromioclavicular joint is part of the shoulder complex, where the collar bone links in to it. The shoulder is a synovial joint; it is encased by a capsule which is filled by fluid which helps to cushion and lubricate it.

Common Pathology of the Shoulder

Impingement

Impingement is a common complaint in the shoulder and occurs when the bursa (fat pad) or muscles in the shoulder region get compressed during elevation (overhead) movements. It can be a very painful condition and can persist if not treated correctly. There are a number of possible reasons for this to occur, such as posture, direct injury and repetitive injury

Rotator Cuff

The rotator cuff is the term used to describe the group of four muscles which surround the shoulder joint. They are responsible for a large part of the stability and motion of the shoulder complex. Damage can occur after trauma such as a fall onto the arm, and they can also be damaged gradually as we age. Damage will result in a tear, which may be partial or a full thickness tear. Pain from a rotator cuff injury is common at night and can radiate down the arm.

Frozen shoulder

The shoulder joint is surrounded by a thick fibrous band of tissue known as the capsule. This is usually very elastic and flexible. When frozen shoulder develops this capsule becomes inflamed, contracted and swollen often resulting in quite severe pain. A frozen shoulder goes through different phases, initially of pain, the stiffness and after this a gradual phase of resolution. The whole process can last 2-3 years in some cases and can occur spontaneously or after a minor injury.  

Labral tear

The rim of the glenoid is made up of a fibrous ring of cartilage and is known as the labrum. This helps to create stability by deepening the shoulder joint. The labrum can be torn, often in sports involving throwing, tackling, weightlifting or pulling of the arm. It can also be damaged during a dislocation. Symptoms include pain and clicking in the shoulder, and it can often worsen over time if not addressed.

OA

Osteoarthritis of the shoulder is less common than in the hip or knees, but it can still become a debilitating condition. Osteoarthritis is a progressive degeneration of the joint as the cartilage surfaces wear away as we age. If this occurs at a significant rate, pain and stiffness can be the result. This can greatly affect a patient’s lifestyle.

Treatment

The White House Clinic is much more than just a regular physiotherapy clinic. We have the ability to facilitate any intervention that is needed to help manage and rehabilitate any type of shoulder injury or issue. The information below outlines all of the services available at the clinic.
Physiotherapy assessment and treatment

We have a group of highly experienced physiotherapists who will be able to provide a thorough assessment and diagnosis of your shoulder issue. Following this they will be able to provide you with the most evidence-based treatment to ensure improvement and hopefully resolution of your symptoms. We have a shoulder specialist physiotherapist who is able to assess, advise and treat more complex issues as well.

In the case where further investigations or treatment is required, they have the knowledge base and contacts to make sure the appropriate onward referrals are made with minimal waiting times.

State-of-the-art gym and rehabilitation facilities

Our clinic is equipped with both a gym and a studio both filled with modern equipment enabling our physiotherapists have the facilities to provide the best rehabilitation available.

Rapid access to investigative and scanning facilities

If you require further investigation such as an x-ray or MRI scan, we have the clinical pathways to refer you quickly. Many shoulder issues can be assessed with an ultrasound scan which we are able to perform in house with no waiting list.

Corticosteroid injections

In certain situations, an anti-inflammatory, pain relieving injection known as a corticosteroid injection is used in the management of shoulder pain. We are able to provide these injections on site.

Direct referral links to the top orthopaedic specialists in the area

We have long standing professional relationships with the top orthopaedic specialists in the area so in the scenario where an orthopaedic referral, possibly leading to surgery, is required we are able to refer swiftly and directly.

Pre-operative and Post-operative rehabilitation

We have a vast amount of experience in dealing with patients before and after shoulder surgery with many of the local hospitals referring a large variety of surgical cases to us.
Prior to surgery it is best practice to optimise the range of movement and strength of the shoulder joint which will allow for a quicker recovery after surgery

After surgery there is a surgical protocol that is followed. Our physiotherapists will be able to guide you through this protocol to ensure optimal recovery is achieved.

Summary

At the White House Clinic we are able to help you with any form of shoulder issue at any stage of the process to recovery.
The shoulder joint can be a source of pain and decreased function for many people however there is almost never a situation where you ‘just have to live with it’.

If you have any questions about your shoulder or any of the services that we provide then get it contact with us today and we will be happy to help.

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