Bodypart Of The Month: The Shoulder

Next in our Bodypart Of The Month series is the shoulder. We asked our specialist shoulder physiotherapist, Nick Smith, to tell us all about it.

The Shoulder

The shoulder, or Glenohumeral joint (GHJ) is a ball-and-socket joint like the hip joint. The hip joint has a ball that sits in a very deep socket making the joint very stable.  The ball of the shoulder loosely fits in a shallow cup (the glenoid). It is very much like a golf ball on a tee. The GHJ has the greatest mobility of any joint in the body, but is less stable than the hip and more prone to injury.

Soft tissue structures helping to stabilise the GHJ include:

• Joint capsule and ligaments.

• Glenoid labrum - a ring shaped cartilage structure that increases the depth of the glenoid by 50%.

• Rotator cuff (RC) muscles, deltoid and long head of biceps.

In the shoulder there are 6 bursa, sacs filled with fluid found between tissues (bone, skin, tendons and muscle), acting as a cushion to decrease the friction and the irritation between the tissues that move between each other.

When your shoulder works well

When your shoulder is working well the rotator cuff (main function is to keep head of the humerus centred in the glenoid as the shoulder moves, and to lift and rotate the shoulder in the many directions) muscles are working together allowing your shoulder to function without pain and you can participate in your chosen sport or activity.  

When your shoulder doesn’t work well

When your shoulder is not working well this can lead to soft tissue inflammation and possible damage. Injuries include rotator cuff tendonitis and tears, Sub acromial pain (impingement), SLAP (labrum) cartilage tears and bursitis.

Common shoulder injuries

Shoulder dislocation, often due to trauma and falling on an outstretched arm, is a common injury I see in clinic. Most dislocations respond well to physiotherapy and rehabilitation. Occasionally surgical stabilisation may be required if you sustain bone and soft tissue trauma during the dislocation.

Rotator cuff tears are also a common injury and are caused by injury, overuse and degeneration. The treatment of rotator cuff tears depends on the size and location of the tear. Small tears can be managed with physiotherapy and strengthening exercises. Full thickness tears will require surgical repair and then physiotherapy.

Avoiding shoulder injuries

Don’t over load your shoulder too hard too quickly. Build up your strength, resilience and tolerance to load. Ensure you have to correct technique for your chosen sport and activity.

Got shoulder pain or niggles? Call us to make an appointment with Nick on 02030 12 12 22.

Words by Nick Smith.