Shoulder is a shallow ball and socket joint, it provides good flexibility but vulnerable to instability.
SHOULDER REGION BASIC ANATOMY
The shoulder joint is made up by four joints, including Sterno-clavicular joint, acromio-clavicular joint, gleno-humeral joint and scapula-thoracic joint. The first three joint are true synovial joint while scapulo-thoracic joint is the articulation between scapula and thoracic without synovial structure.
Shoulder joint permits six direction of motion, including flexion, extension, abduction, adduction, internal and external rotation. Scapula-thoracic rhythm is important for its role of rolling scapular, in order to maximise space of arm flexion or abduction. In clinical practice, patient need to learn regain scapula-thoracic rhythm by strengthening rotator cuff muscle.
Conditions that cause shoulder pain
- Sub-Acromial Impingement: sub-acromial space narrowing by tendonitis or bursitis
- Frozen Shoulder: known as Adhesive Capsulitis
- Long Head Biceps Tendonitis
- Acromioclavicular Joint Separation
- Scapular Joint Dysfunction
- Rotator Cuff Tears
- Multidirectional Instability
Frozen Shoulder
Frozen Shoulder is known as adhesive capsulitis, it is characterised by gradually increase of shoulder pain and shoulder stiffness in both active and passive range of glenohumeral joint motion. Early exercises are suggested until signs of acute inflammation have already subsided. In very early stage, active exercises, such as pendulum exercise, can be initiated to preserve shoulder joint flexibility. In later stage, gleunohumeral and scapulothoracic range of motion and strength exercises will be coporated in daily training.
How Traditional Chinese Medicine and Physiotherapy help?
Acupuncture and dry needling
Acupuncture is safe and effectively treat chronic neck pain.
Manual therapyRelease muscle tightness, improve joint alignment and function.
Chinese Herbal RemedyNature way of Pain Killer, and improve sleep quality.
Exercise TherapyPromote injured tissue healing, improve the function of the affected area.
REFERENCE:
1. Akbar, M., McLean, M., Garcia-Melchor, E., Crowe, L. A., McMillan, P., Fazzi, U. G., Martin, D., Arthur, A., Reilly, J. H., McInnes, I. B., & Millar, N. L. (2019). Fibroblast activation and inflammation in frozen shoulder. PLOS ONE, 14(4). https://doi.org/10.1371/journal.pone.0215301
2. Liu, S., Wang, Z., Su, Y., Qi, L., Yang, W., Fu, M., Jing, X., Wang, Y., & Ma, Q. (2021). A neuroanatomical basis for electroacupuncture to drive the vagal–adrenal axis. Nature, 598(7882), 641–645. https://doi.org/10.1038/s41586-021-04001-4
COMMONLY SEEN CONDITIONS
