By: Andrew O’Donnell, PT, DPT, OCS and Clinic Manager at ApexNetwork Physical Therapy in Ballwin, MO
Pain presenting in and around the shoulder is one of the most common complaints treated by physical therapists in the orthopedic setting. Estimates of shoulder pain across United States are as high 20% of the population at any given time. Possible sources of these complaints are many, to name a few: nerve irritation, tendinopathy, bursitis, and osteoarthritis. Depending on activity, injury is sometimes unavoidable, however repetitive use injuries are both common and preventable. Scapular dyskinesis, in layman’s terms, means the inability to control or coordinate movement of the shoulder blade. Here’s why this is important:
The shoulder or glenohumeral joint is a complex joint made up of the contact between the head of the humerus (think golf ball) sitting on the glenoid of the scapula (think golf tee). This joint relies heavily on its ligamentous and muscular support as it sacrifices bony stability to achieve high degrees of multiplanar mobility. Moving the shoulder properly in any plane requires highly coordinated and sequential timing of the muscles of the shoulder blade. Faulty mechanics over time can cause repetitive microtrauma (think little injuries over and over again) to the tissues surrounding the shoulder joint and lead to pain, analogous to driving a car with poor alignment which would lead to abnormal tire wear.
So what happens to your shoulder blade when you lift your arm overhead? Hopefully it is operating from a stable base to your spinal column, maintaining good contact with your ribcage, rotating upward approximately 60 degrees, and not tipping forward, winging out, hiking up or any number of other potential faulty movements. As you can see, the shoulder blade and all 17 muscles that attach to it is critical in how the arm is moved. Fortunately, an evaluation by an ApexNetwork Physical Therapist will identify your strengths (and weaknesses), areas of inflexibility (or excessive mobility) and areas of stiffness from the joint, spine, or other structures.