What to Know About Front Shoulder Pain

From Medical News Today; Medically reviewed by William Morrison, M.D. — Written by Sunali Wadehraon January 22, 2019

Damage to the shoulder may result from repetitive movements, manual labor, sports, or aging. A person may also injure this part of the body due to a bad fall or accident. Many people visit the doctor with front, or anterior, shoulder pain.


The shoulder is a mobile structure that allows the arm to move freely in all directions. Shoulder problems may limit arm movement, causing pain or discomfort.

The shoulder has three major bones:

  • the humerus, which is the long arm bone
  • the scapula, or shoulder blade
  • the clavicle, or collarbone

These bones interact at four joints. A joint called the glenohumeral or shoulder joint connects the upper arm bone and shoulder blade. Although surrounding structures provide support, this joint is susceptible to injury.

In this article, we discuss some common causes of front shoulder pain and explain how doctors diagnose and treat them.

What are the causes?

Shoulder pain can develop from problems in any part of the shoulder.

Damage to the joint may result from repetitive movements, manual labor, sports, or aging.

It may also occur when a person has a bad fall or accident.

Some injuries may cause a sudden onset of shoulder pain. Examples include dislocations, separations, and fractures.

Common causes of chronic front shoulder pain include the following:

Rotator cuff injury

The rotator cuff comprises muscles and tendons that act to stabilize the shoulder.

Bursae, which are fluid-filled sacs, reduce friction between the shoulder structures. The rotator cuff tendons, which connect the muscles to the bone, are vulnerable to compression from surrounding bony structures.

Rotator cuff tendinopathy, or injury to the rotator cuff tendons, may develop from repetitive activity, generally at or above shoulder height. People with rotator cuff tendinopathy may have pain around their shoulder, particularly when reaching overhead.

Impingement occurs when the acromion, a part of the shoulder blade, puts pressure on the rotator cuff tendons and bursae. It presents in an almost identical way to rotator cuff tendinopathy.

Rotator cuff tendon tears may result from sudden injury or slow, degenerative change. Symptoms include shoulder weakness and pain, as well as popping sensations during arm movement. Severe tears may impair the use of the shoulder, limiting day-to-day activities.

Biceps tendinopathy

Biceps tendinopathy is an injury to the tendon of the biceps muscle, which may result from repetitive lifting and reaching overhead. Symptoms include pain in the front of the shoulder that becomes worse when lifting, reaching overhead, and carrying objects. Continued performance of these activities may result in the sudden rupture of the tendon.

Adhesive capsulitis

Adhesive capsulitis, which people sometimes refer to as frozen shoulder, may develop from not using the shoulder. People with this condition may experience pain, a decrease in their range of motion, and stiff joints. Common causes of shoulder disuse include rotator cuff tendinopathy, diabetes mellitus, biceps tendinopathy, and trauma to the shoulder.

Osteoarthritis

Osteoarthritis, also known as “wear and tear” arthritis, commonly occurs in either the glenohumeral joint or the acromioclavicular joint. In this form of arthritis, the bones rub together as the cartilage between them wears away. Symptoms include pain, swelling, and stiffness in the shoulder joint.

Osteoarthritis generally worsens over time.

Fracture

Fractures, or breaks, occur most often in the collarbone or upper arm bone. Both types of fracture may result from a fall onto an outstretched hand or a blow to the shoulder. In most cases, they will cause severe pain, swelling, and bruising. The shoulder will be tender to touch around the injury, and the bones may appear out of position.

Dislocation

Shoulder dislocations occur when the ball of the upper arm bone pops out of its socket. The arm bone may dislocate forward, backward, or downward, either partially or completely.

Dislocations may recur if the surrounding structures of the shoulder become worn down. Symptoms include pain, swelling, numbness, and weakness. The arm may look out of place.

Separation

A shoulder separation occurs when the ligaments tear. The ligaments are tissues connecting the bones and cartilage. Separations in the acromioclavicular region between the collarbone and shoulder blade may occur from falls or direct blows. Symptoms include pain, swelling, and tenderness in the front shoulder, as well as a bump at the point of separation.

Treatment

People can manage many types of shoulder problem at home.

Treatment typically involves a period of rest and avoidance of activities that aggravate the pain.

A doctor may also recommend applying heat or ice to the injury for pain relief, as well as placing pressure on the area to reduce swelling. Physical therapy improves shoulder strength and flexibility.

Slings can be helpful in managing shoulder dislocations, separations, and fractures, as they keep the structures of the joint in position. Before applying a sling, a doctor will put the bones back into place.

Sometimes, doctors recommend medication to reduce pain and inflammation. Over-the-counter drugs, such as ibuprofen and aspirin, are available. Doctors can also prescribe medications and inject steroids or numbing medicine directly into the shoulder to relieve pain.

Some injuries require surgery for treatment. For example, rotator cuff tears and adhesive capsulitis do not always improve with rest and medicine. Severe rotator cuff tears or recurrent dislocations may warrant early surgical consultation rather than a trial of at-home management.

Diagnosis

Several conditions lead to shoulder pain.

A thorough clinical evaluation helps pinpoint the cause. A doctor will take a medical history and carry out a physical examination, during which they may ask the individual to perform several specific movements to assess the injury. They may also order lab and imaging tests if they need additional information.

If the pain is mild, it may not be necessary to visit a doctor right away. Some people prefer to rest and see if the pain will go away. If the pain does not improve, it is best to go to the doctor for further evaluation.

People should see a doctor right away if they experience any of the following signs or symptoms:

  • intense pain
  • sudden swelling
  • weakness or numbness in the arm or hand
  • inability to use the shoulder
  • deformity

Takeaway

Shoulder pain is a common complaint. The unique anatomy and range of motion of this joint make it susceptible to injury. Common triggers for injury include accidents, repetitive movements, manual labor, sports, and aging.

An injury that causes severe pain requires immediate care. A person should also see a doctor right away if they have any joint deformity, sudden swelling, an inability to use the joint, weakness or numbness in the arm or hands, or intolerable pain.

 


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Tips for Exercising When You Have Osteoarthritis

By K. Aleisha Fetters | Featured on US News

IF YOU HAVE osteoarthritis, your relationship with exercise is bound to be a tricky one. After all, increasing physical activity is one of the fundamental must-dos for managing the degenerative wear-and-tear joint disease and slowing its progression. But if you have osteoarthritis, certain exercises can be incredibly painful and contribute to further joint damage.

That’s why it’s critical to take a smart, measured approach to exercise if you’re one of the more than 30 million Americans that has osteoarthritis, according to the Centers for Disease Control and Prevention.

Here are seven pro pointers for reaping all of the joint-protecting benefits of exercising with osteoporosis and reducing the risk of exercise aches and pains:

  • Consult with a specialist.
  • Warm up.
  • Focus on low-impact workouts.
  • Use your full range of motion, as long as it’s pain-free.
  • Learn isometric exercises.
  • Keep things short and frequent.
  • Tune into your body and adjust as necessary.

Consult With a Specialist

Discussing your individual joint health, symptoms and exercise history with an expert is the perfect starting point when increasing physical activity with osteoarthritis, says Katrina Pilkington, a Nevada-based National Academy of Sports Medicine certified personal trainer and corrective exercise specialist. She recommends reaching out to your rheumatologist and getting set up with a personal trainer or physical therapist.

Working with a trainer or physical therapist is especially important if you have never worked with one in the past. Both can teach you the fundamentals of exercise form to ensure you perform all activity in the safest, healthiest manner for you.

Warm Up

When you’re short on time, it can be tempting to dive straight into your workout, but don’t give in. It’s critical to take a few minutes at the beginning of any exercise routine to increase blood flow to the muscles and joints you’re about to work, according to the Arthritis Foundation. Some gentle warmup drills include arm circles, side-to-side marches, partial bodyweight squats and light cardio, such as walking and cycling.

Focus on Low-Impact Workouts

High-impact exercises involving running and jumping can help strengthen your bones, joints and their supporting musculature, but this isn’t the best starting place for anyone with joint disease. “I would recommend starting with lower-impact exercises and gradually progress based on how you feel,” says physical therapist William Behrns, a board-certified Orthopedic Clinical Specialist at the Hospital for Special Surgery in New York City.

Great low- and no-impact forms of exercise include cycling, swimming and strength training, in which both feet stay planted on the floor at all times. For example, instead of stepping back and forth during lunges, performing them with a stationary split stance eliminates any potential jolting of your ankles, knees and hips. Similarly, swap out jump squats for goblet squats (where you hold a single weight in front of your chest) to work your muscles just as hard while reducing potentially irksome stress to your joints.

Use Your Full Range of Motion as Long as It’s Pain-Free

Your joints’ ability to freely move is contingent on regular movement, Pilkington says. It’s a use-it-or-lose-it scenario. However, it’s important that you don’t force your body into painful positions.

For example, maybe you can get into a very low squat, but it hurts your knees and/or hips. Stick to a shorter range of motion, bending at the hips and knees only as far as you can do so without pain, Behrns says.

Learn Isometric Exercises

In some joints, just about any motion can be painful – and that’s where isometric exercises come in handy. In them, rather than moving up and down or side to side, you hold a position.

With isometric exercises, it’s important to remember that you’ll only challenge and strengthen your muscles in the positions that you’re holding. So, if possible, hold each exercise in multiple positions. For instance, if you’re performing isometric lunges, try holding the exercise for 30 seconds near the bottom of your available range of motion and again for 30 seconds near the top.

Other isometric exercises to try include squats, glute bridges and shoulder raises. These are particularly helpful since osteoarthritis most commonly affects the knees, hips and shoulders.

Keep Things Short and Frequent

Sprinkling short activity sessions throughout the day is a great way for anyone to fit exercise into their daily routine and break up time spent sitting. But for anyone with osteoarthritis, short activity sessions can also be useful in ensuring that, when you do exercise, you don’t overstress your joints, Pilkington says.

Any movement, no matter how brief, counts toward your daily activity goals. Behrns recommends getting 150 cumulative minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week. A combination of the two also works.

Tune Into Your Body and Adjust as Necessary

Exercising with osteoarthritis can be frustrating, especially if exercise mistakes contributed to your condition or you’re a longtime exerciser who’s suddenly limited in what your body can and can’t do.

However, if you move forward based on how your body feels – rather than what you’re used to or what you expect your body to do now – you’ll be far better off, Behrns says. He recommends listening to your symptoms and if you experience any pain, to immediately think through what aggravated your body and do something about it. That could mean switching up exercise variations, scheduling more recovery work into your routine or adjusting the time during the day that you work out.

 


Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

6 Exercises for Osteoarthritis

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OSTEOARTHRITIS IS THE most common type of arthritis, affecting 31 million people in the U.S., says Marcy O’Koon, senior director, consumer health, Arthritis Foundation.

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Easing the Pain of Osteoarthritis of the Knee

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There’s been more than one study suggesting massage therapy helps relieve the pain associated with osteoarthritis of the knee. More recently, the results have again been affirmed by research supported by the National Center for Complementary and Alternative Medicine.

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Osteoporosis and Spinal Fractures

Article Featured on AAOS

As we get older, our bones thin and our bone strength decreases. Osteoporosis is a disease in which bones become very weak and more likely to break. It often develops unnoticed over many years, with no symptoms or discomfort until a bone breaks.

Fractures caused by osteoporosis most often occur in the spine. These spinal fractures — called vertebral compression fractures — occur in nearly 700,000 patients each year. They are almost twice as common as other fractures typically linked to osteoporosis, such as broken hips and wrists.

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Osteoarthritis of the Hip

Article Featured on AAOS

Sometimes called “wear-and-tear” arthritis, osteoarthritis is a common condition that many people develop during middle age or older. In 2011, more than 28 million people in the United States were estimated to have osteoarthritis. It can occur in any joint in the body, but most often develops in weight-bearing joints, such as the hip. Read more