The shoulder is a really mobile joint: think about all the different directions your arm can move in.
However, moving your arm doesn’t happen in isolation. No. We also have to consider the movement of the shoulder blade (the scapula). Notice what happens to your scapula when you take your arm out from your side up to 90 degrees so that your arm is parallel to the floor and then even higher until it is by your ear. Can you feel the scapula change position against your ribs? Perhaps you notice how the space near the bottom of the scapula and your spine widens as your arm raises upwards.
Oh, and did I mention your collarbone? Well, your collarbone is also known as the clavicle and your scapula attaches to the clavicle. Raise your arm forwards up to your ear and back down and feel how your clavicle moves.
All these bony structures need to move smoothly to ensure that the arm has full range of movement. They move because your ligaments and muscles support the joints and enable various movements to occur. And as bones move, ligaments offer support, muscles contract or stretch, there are little fluid filled sacs called bursa, which are a bit like gel packs, that act as cushions to help maintain friction free movement. In amongst all of these structures there are also blood vessels, lymphatics and nerves to consider.
Yep. The shoulder is complex!
When you fall or lift something heavy and hurt your shoulder there is an acute injury and it is easier to identify the problem then treat and rehabilitate it. However, often a shoulder problem develops over a period of time. These chronic shoulder issues are more challenging as the causes can be varied and the solution not so clear cut.
Fortunately, when trying to resolve a chronic shoulder issue, we don’t need to eliminate all the options one by one. We can assess range of motion to identify which are the most likely structures and movements that need to be worked on. We can devise a series of exercises to help with improving certain movements. If there is an injury, we can give the body time to heal as different structures take different times to recover, which is why it is important not to work when there is pain. We can work on getting a better balance in activities that might be contributing to restrictions in movement.
Your shoulder functions so well because so many structures work together to optimise its movement.
When something goes wrong with your shoulder, we can work together to restore better movement. Teamwork.