Are you having shoulder pain, shoulder weakness, and difficulty with performing self-care, home activities, work tasks or hobbies? Has your posture become more rounded and your head more forward? Have you lost shoulder range of motion? Do you have pain when reaching overhead or behind your back? Have you become unable to lift your arm up overhead—even though you have the range of motion available?
All of these are signs and symptoms of an aging shoulder joint. Paying attention to these early signs and symptoms can prevent more serious injuries and degeneration, which could impact your ability to maintain your independence in your own home. Failure to address these symptoms early in their presentation can lead to such conditions as osteoarthritis, impingement, bursitis, tendonitis, and rotator cuff tears.
Our shoulders are a vital part of our mobility, function, and independence. They are used throughout the day for such important tasks as brushing our teeth, getting dressed, making meals, cleaning our homes, driving a car, performing yardwork, working, picking up grandchildren, and enjoying our hobbies. These activities can create general wear and tear on the shoulder complex over time; leading to injury.
Our shoulder complex is made up of the humerus (upper arm), clavicle (collarbone), and scapula (shoulder blade). The shoulder joint has a loose capsule and smaller ligaments which allow it to move through extreme ranges of motion. The shoulder relies primarily on the rotator cuff for its stability. Numerous other muscles cross or attach in the shoulder complex aiding in its function. Ultimately, the shoulder is designed to be highly mobile and strong, so that we can perform self-care, household tasks, work tasks, and hobbies without difficulty.
In order to prevent shoulder deterioration and injuries, care must be taken to maintain full range of motion, full strength, and good posture. When our shoulders become more rounded, the shoulder and scapula muscles become stretched out and lose their ability to contract strongly. Poor posture can also lead to changes in joint alignment, which can cause pinching of the rotator cuff tendons, formation of bone spurs under the clavicle, and inflammation of the bursa in the shoulder joint region. To battle these changes, it is important to perform daily stretching exercises and light strengthening exercises. It is also important to fight the affects of gravity by standing up tall to foster good posture.
There are also many preventative things that you can do around your home to decrease the wear and tear on the shoulder joint. Look for opportunities to lessen the load on your shoulders by using lighter weight dishes/pots and smaller containers of milk. Place frequently used items between waist and chest height. Break up harder and heavier tasks into shorter periods of time. Lastly, seek out help for tasks which are difficult or cause pain- like vacuuming, carrying groceries and shoveling snow.
It is always important to listen to your body’s cues. Once pain begins to develop in the shoulder joint, it is important to modify activities and selectively rest the shoulder joint. A simple rule to follow is “if it hurts don’t do it”. Use of cold pack applications, gentle range of motion, and over the counter medications can help to manage early symptoms. If symptoms do not subside within a few days, it is important to seek medical attention to address your needs. Ignoring the symptoms and hoping that they will go away can lead to a more severe injury.
Most shoulder pain can be managed with conservative care including ice, rest, and early consultation with medical professionals, including orthopedists and physical therapists. In some cases, a cortisone injection or medication may be of benefit to quickly decrease pain and inflammation. Surgery is considered to be a last resort; after conservative management has not been successful.
By following a preventative program of daily range of motion and strengthening exercises, improvement of posture, use of lighter items around the home, modification of heavier tasks when necessary, and early medical intervention if symptoms don’t subside; one can deter serious shoulder injuries and maintain independence in the home.
Dr. Lori Schneider is a Physical Therapist and Regional Director for Access Physical Therapy and Wellness.