Shoulder Pain: Causes and Rehabilitation Insights

Q: Shoulder Pain: Causes and Rehabilitation Insights

Hello, Ms. <br>Shui：<br>The shoulder joint consists of four joints, with the glenohumeral joint having the greatest range of motion. <br>Its dynamic stability is provided by muscles, ligaments, and the glenoid cavity. <br>Due to your long-term habit of carrying a heavy bag on you

Shoulder issues

Hello Doctor: I have been experiencing pain in my left shoulder for the past few years.
Whenever I carry a backpack for more than 20 minutes, my shoulder starts to hurt, and it feels like it might dislocate.
In high school, I often carried heavy items to school, and I could only carry them on my left shoulder; carrying on my right shoulder would cause headaches and nausea (which I believe is largely due to habit or psychological reasons).
I have been under this load for three years, and sometimes when I reach down to grab something from under a chair, the pulling of the shoulder muscles causes severe pain.
However, resting and applying pressure on the area gradually alleviates the symptoms.
I have researched some information, but I couldn't find the answers I was looking for due to individual differences.
Could you please tell me what condition this might be? I do not experience pain while using the computer or studying; it only occurs when standing, walking, or carrying something that requires my shoulder to bear the load.
After walking for a while, my shoulder starts to hurt, which gives the impression that I am exaggerating my discomfort.
Therefore, I hope you can provide me with some direction to follow.
Thank you for your response!

Shui, 20~29 year old female. Ask Date: 2005/10/28

Dr. Xu Zhenrong reply Rehabilitation

Hello, Ms.
Shui:
The shoulder joint consists of four joints, with the glenohumeral joint having the greatest range of motion.
Its dynamic stability is provided by muscles, ligaments, and the glenoid cavity.
Due to your long-term habit of carrying a heavy bag on your left shoulder, the muscles attached to the shoulder (such as the upper fibers of the trapezius, levator scapulae, and supraspinatus) may be subjected to prolonged pressure, leading to fatigue-related injuries.
Over time, any activity requiring shoulder exertion may result in pain or discomfort, especially during movements that require a greater range of motion.
Poor posture over extended periods can also lead to similar issues, and you may frequently complain of shoulder and neck pain.
Recommendations:
1.
Try to avoid carrying overly heavy bags to prevent exceeding the shoulder's load capacity (especially with crossbody and side bags), and use your right shoulder for carrying weight.
2.
Pay attention to your posture; maintain a neutral position with your body, ensure both shoulders are level, and avoid slouching (whether sitting, standing, or lying down).
3.
Perform gentle and simple stretching exercises:
(1) While standing or sitting, relax your entire body, then simultaneously move both shoulders, such as repeatedly shrugging and relaxing them, followed by rotation movements.
(2) In a standing position, interlock your hands and stretch upwards while incorporating gentle deep breathing.
(3) Engage in low-impact recreational activities, such as swimming, which not only mobilizes the shoulder joint but also strengthens shoulder muscle strength and endurance, helping to prevent further injury.
If you wish to further understand your condition, I recommend visiting a nearby major hospital to consult the rehabilitation department for a more detailed examination, assessment, and treatment.
Thank you very much for your inquiry, and I hope this response is helpful to you.

Reply Date: 2005/10/28

More Info

Shoulder pain can be a complex issue, often stemming from a variety of causes, including muscle strain, tendonitis, bursitis, or even more serious conditions like rotator cuff injuries or impingement syndrome. Based on your description, it sounds like your shoulder pain may be related to overuse and possibly poor posture, especially given your history of carrying heavy loads on one shoulder.

Possible Causes of Your Shoulder Pain
1. Muscle Strain: Carrying heavy backpacks, especially on one shoulder, can lead to muscle strain in the shoulder and upper back. This can cause pain and discomfort, particularly if the muscles are not conditioned for such loads.

2. Rotator Cuff Issues: The rotator cuff is a group of muscles and tendons that stabilize the shoulder. Overuse or repetitive strain can lead to inflammation or tears in these tendons, resulting in pain, weakness, and limited range of motion.

3. Shoulder Impingement: This occurs when the shoulder blade puts pressure on the underlying soft tissues when the arm is lifted. It can cause pain and limit movement, especially during overhead activities.

4. Postural Problems: Poor posture, especially when sitting or standing for long periods, can lead to muscle imbalances and pain. If you tend to lean to one side or carry weight unevenly, this could exacerbate your shoulder pain.

5. Nerve Compression: Sometimes, issues in the neck can lead to referred pain in the shoulder. Conditions like cervical spondylosis or herniated discs can compress nerves that affect shoulder function.

Rehabilitation and Management Strategies
1. Physical Therapy: A physical therapist can assess your shoulder and develop a tailored rehabilitation program. This may include strengthening exercises for the rotator cuff and shoulder blade muscles, flexibility exercises, and postural training.

2. Ergonomic Adjustments: If you spend a lot of time at a desk or using a computer, ensure your workstation is ergonomically set up. Your chair, desk height, and monitor position can all affect your posture and shoulder health.

3. Gradual Load Management: If you need to carry a backpack, try to distribute the weight evenly across both shoulders. Consider using a backpack with padded straps and a hip belt to help distribute the weight more evenly.

4. Stretching and Strengthening: Incorporate stretching exercises for the shoulder and upper back to improve flexibility. Strengthening exercises for the rotator cuff and shoulder stabilizers can help support the joint and prevent further injury.

5. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation. However, consult with a healthcare provider before starting any medication.

6. Rest and Recovery: If you experience pain during certain activities, it’s essential to rest and allow your shoulder to recover. Avoid activities that exacerbate the pain until you can strengthen the area.

7. Mind-Body Techniques: Since you mentioned that certain activities trigger pain, consider exploring relaxation techniques such as mindfulness or yoga, which can help reduce muscle tension and improve your overall body awareness.

Conclusion
It’s crucial to address shoulder pain early to prevent it from becoming a chronic issue. If your symptoms persist or worsen, it’s advisable to consult a healthcare professional for a thorough evaluation. They may recommend imaging studies like an MRI to rule out any serious underlying conditions. By taking proactive steps in rehabilitation and making lifestyle adjustments, you can significantly improve your shoulder health and reduce pain.

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