In Australia, shoulder pain is the third most common musculoskeletal condition seen in general medical practice. Rotator-cuff related pain is the most common cause of shoulder pain. The pain is often localized to the anterolateral aspect of the shoulder, aggravated with overhead activity. [1] The reason that the shoulder is prone to injury is because of its structure. The shoulder bones are composed of the clavicle (collarbone), the scapula (shoulder blade) and the humerus (upper arm bone). The muscles, ligaments, tendons, and soft tissues connect between those structures, allowing one of the most flexibility of our body. Because of this flexibility, it’s not very stable and is easily injured. The rotator-cuff tendon, which bridges muscle to bones and joints, is a white coloured tissue. This is because the structure has less blood circulation compared to red-meat, the muscles. When it gets injured, it takes longer to heal due to less blood circulation. During the rehabilitation phase, focus is to strengthen and gradually increase the mobility of the relevant muscles.
Things you can do
Knowing the unstable structures of the shoulder and less blood circulation to the tendons, it is best to avoid injuries in the first place. Strengthening exercise including deltoids, trapezius muscles, rhomboids, teres muscles and supraspinatus can reduce the load through tendons, preventing overloading. [2] Increasing muscle mass surrounding the shoulder will also increase blood circulation in the area. Before any strenuous activities including exercise, shoulder warm up is important to get blood flow to the area.
If you have injured your shoulder, it is best to seek medical attention as soon as possible. Further damage could occur if you continue to use your shoulder.
After a rest period post surgery or injury, it is best to start your shoulder rehabilitation to gain mobility and strength for fast recovery and avoid further damage. The rest period should be guided by your doctor or physical therapist.
Acupuncture and Herbs
Acupuncture can help to reduce your pain and to maximize your blood circulation to the affected area. When I was working in the hospital or medical clinic as a registered nurse, doctors generally did not recommend acupuncture concerning potential infection to the affected area. However, my acupuncture style does not insert any needles to your affected shoulder but mostly to the distal points (close to hands or feet) or opposite to your injury side. It still contributes to the improvement of therapeutic effects. Herbs are mainly chosen to improve circulation to the area to maximize tissue healing. As mentioned above, injuries involving tendons take longer due to less blood circulation so improving circulation may reduce the number of recovery days.
Reference
Naunton J, Harrison C, Britt H, Haines T, Malliaras P (2020) General practice management of rotator cuff related shoulder pain: A reliance on ultrasound and injection guided care. PLoS ONE 15(1): e0227688. https://doi.org/10.1371/journal.pone.0227688
OrthoInfo [Internet]. Rotator Cuff and Shoulder Conditioning Program; [updated 2022 Jun; reviewed 2023 Jun 2; cited 2023 Jun 4]. Available from:https://orthoinfo.aaos.org/en/recovery/rotator-cuff-and-shoulder-conditioning-program/
Image [Internet]. Shoulder Pain at Night While Side Sleeping | Solutions and Relief; [updated 2023 Mar; cited 2023 Jun 4]. Available from: https://pillowpod.com.au/blogs/pillow-pod/dont-let-shoulder-pain-keep-you-awake-causes-and-solutions
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