The underlying pain in the shoulder joint may be degenerative changes. They occur with age as a result of “wear” of the joint, although it happens less often than in other joints. Sometimes shoulder pain can be the beginning of a rheumatic disease, but it is rarely a manifestation of serious organ diseases, including a heart attack or a lung tumor.

Construction of the shoulder joint. The sub-shoulder space is located under the shoulder process. This is a very important area because there are muscle tendons called the rotator cuff and bursa that allow the joint structures to move smoothly while lifting the arm.

The rotator cuff is made up of the four muscles that surround the shoulder-scapular joint. In addition to allowing rotational movements, they keep the head of the humerus in the correct position in relation to the scapula.If we make frequent movements with our arms above the head (e.g. hanging curtains, painting), we can compress the tendons of these muscles and damage them, and sometimes even tear them off.

Overload damage to the rotator cuff starts with a slight pain that builds up over time, preventing free movement. The cause of damage to the rotator cuff may also be injuries, even minor ones (e.g. sudden jerking while driving a tram).

If there is a “tightness” in the subacromial space (as a result of improper muscle action or repetitive flexion movements and abduction over 90 degrees), the movement of the humerus from sliding under the shoulder process is blocked. This can lead to inflammation of the bursa or the formation of bone spurs and further degenerative changes.

Shoulder pain – what to do? The pain of bursitis is severe and movement is limited. As a consequence, the tendons of the rotator cuff and vicious circle may be damaged (cone damage – bursitis – cone damage). Another cause of shoulder pain may be damage to the tendon of the long head of the biceps. This tendon runs vertically in front of the brachial.

The pain accompanying the injury occurs precisely in this area and occurs especially during movements with the bent elbow. This tendon sheath inflammation occurs in the case of mechanical damage, as well as as a result of inflammatory diseases of the joints. The frozen shoulder is caused by shrinkage of the shoulder joint capsule, which makes it impossible to perform the full range of movements.

The main symptom is a feeling of stiffness in the joint, although pain may also occur. If we feel pain in the shoulder, it is best to immediately go to an experienced physiotherapist who will perform appropriate tests and plan a recovery plan. Sometimes it will be necessary to perform an ultrasound of the shoulder to see if there has been any microdamage.


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