Understanding the First Steps to Resolving your Shoulder Tendinopathy Issue
Shoulder problems can be frustrating, like any other injury, however the complexity of the shoulder region and the ability to have the involvement of a number of different rotator cuff tendons, along with other associated joints in the region, can make indentifying the underlying cause more difficult. Add to this the extra loading on the rotator cuff tendons due to habititual postures from sitting at computers, completing repetitive movement patterns. Add the complexity of sports that involve throwing, serving and hitting the integrity of the shoulder is challenged like no other joint in the body.
The shoulder joint can be one of the most complex areas of the body to address from an injury recovery point of view, aside from the shallow joint allowing greatly improved range of movement, there are a number of closely associated joints in the area that can directly affect the shoulder joint. With respect to the shoulder directly, the integraty of the joint relies heavily on the shoulder rotator cuff tendons to keep the structure functioning at peak performance. As a result shoulder tendinopathy problems are common, but with good management cna be reoslved and you cna return to your activities as previously.
Our team have worked hard to put together a shoulder tendinopathy solution for clients suffering from issues like rotator cuff tendinopathy, impingement syndrome and shoulder instability problems, review our treatment pathway for tendinopathies at www.bodylogichealth.co.uk/resolving-tendinopathies
The shoulder tendons are constantly put under stress, as they are the key soft tissue structures holding the joint in place and allowing the freedom of movement we enjoy. Shoulder injuries are therefore commmon as a result. You may have come across the shoulder rotator cuff complex, a series of four muscles that help hold the shoulder joint into the socket. These comprise of the front of the shoulder and the subscapularis muscle, the top of the shoulder joint and the supraspinatus muscle, while at the back you have the infraspinatus and teres minor muscles. Shoulder injuries will commonly involve one of these muscles, and shoulder injuries are often tendinopathy related as a result. Even if other soft tissues are involved in your shoulder problem you will invariably end up completing shoulder rotator cuff retraining to build the stability back into your shoulder joint and resolve your underlying shoulder tendinopathy issue.
When looking at the shoulder joint you have to consider other factors that can increase the loading in the shoulder joint. In this case there are three areas to consider. The first, and most relevant, is the shoulder blade where the movement patterns of the shoulder blade, or scapular, are important to helping maintain the integrety of the shoulder joint. These two areas work together in synergy to allow good shoulder function and prevent the build up of tendon loading that can lead to a shoulder tendinopathy issue. Unfortunately due to our habits that shoulder blade tends to sit in end range positions, creating excessive loading on the surrounding tissues. It should sit in a mid point and if you shrug your shoulders up and down in front of a mirror, then hold a mid point and complete the same proces for forwards and backwards. Once you have found this mid point does it feel comfortable? If not then it is likely that your shoulder blade is not sitting in a nuetral position and could be adding additional load to your current shoulder injury.
Next you have your thoracic spine, the middle of your back and with all your ribs attached to it. Many of the muscles that attach to your shoulder blade attach into this region and so again the infuence on your shoulder injury can be highly related. It is postural influences that lead to extra stress on your shoulder joint, sitting slouched is a big issue in the modern world and will mean an adaptive change in the position of your shoulder blade and hence further influence on your shoulder joint. This creates loading that will increase the stress on your rotator cuff tendinopathy.
Finally your neck movement and patterns will affect your shoulder joint, either directly as a referred pain mechanism or indirectly with shoulder adaption around restrictions in the neck range of movement. So if you have suffered from neck pain, even historically, then it is worth investigating the influence on your current shoulder pain and how your management plan may need to address both regions to have a fully successful pathway for your shoulder injury or tendinopathy.
There are many different treatment options to address rotator cuff, or shoulder, tendinopathies and the options are discussed in more detail on our dedicated tendinopathy page www.bodylogichealth.co.uk/resolving-tendinopathies , including a discussion on the wonderful effects of shockwave treatment to help settle your shoulder pain to start your journey to recovery.
So we see quite clearly there are a number of related factors that can affect your shoulder tendinopathy issues. These can add and effective drag onto the rotator cuff tendons, while this loading over time will increase the risk of developing a shoulder tendinopathy problem. As such, in the shoulder injury video above we look at helping you understand if you have a tendinopathy issue present so you can then source the right assessment and long term management for your problem. Simply addressing the tendinopathy may not prevent recurrence or resolve your pain, you will need a full managemnet plan put together after careful evaluation of the shoulder injury and related joints.
As a result of the four simple shoulder tests for tendinopathy issues, you get to develop an understanding of the issue further. The four tests for rotator cuff tendinopathies are;
- Infraspinatus / Teres Minor – push your hands out against a wall or resistence from someone else, keeping your elbows in
- Subscapularis – push your hands together against a wall or resistence from someone else, keeping your elbows in
- Supraspinatus I – take your elbows 20 degrees from your sides and resist someone pushing them back down to your sides
- Supraspinatus II – straighten your elbows out fully and bring your hands out in front of you, then turn your thumb down to the ground (better know as the Empty Can Test), again then resist someone pushing your hands gently down towards the gorund
The key for these tests for your shoulder injury is that you observe both pain and power, both and more importantly power can mean there is an issue that will be related to your current shoulder injury, and makes it more likely there is a shoulder tendinopathy present. Essentially you are probably reading this because you have shoulder pain and are trying to understand the nature and cause of your issue. If you find any of the tests completed here are positive then you are likely to have a shoulder tendinopathy issue underlying, as either the primary driver of your shoulder pain or as a secondary factor in a complex shoulder girdle pain issue.
It is time to seek professional help and get to the bottom of your injury and start your journey to movement health. Get back to the lifestyle and activities you enjoy sooner with a management plan that not only removes your pain but builds the foundation in your shoulder region to give you long term security to return to your normal lifestyle. Shoulder pain, in the form of rotator cuff tendinopathies are debilitating but there is a solution for you.
Start Your Shoulder Tendinopathy Recovery Plan Today