“Ongoing Sore Pain at the front of the Shoulder joint”
If you are experiencing sore pain into the front of your shoulder when carrying bags, lifting weights or simply elevating your arm upwards, you may be suffering from Bicipital Tendinitis of the shoulder. Biceps tendonitis involves abnormal frictioning of the biceps tendons in its biciptal groove, which is located the head of the shoulder (humerus head). The bicipital groove is basically a groove or channel imprinted within the bone of the shoulder front so that the tendon is adequately held in place.
The underlying cause of tendonitis to the upper Biceps tendon is abnormal forward tilting of the humeral or shoulder head in its shoulder socket which is seen with people who have rounded shoulders and forward head posture. This results in greater stress applied to the biceps muscles as it has increased responsibility for stabilizing the humeral head within the shoulder joint. Hence repetitive shoulder movement activity brings about friction of the biceps long head tendon against the surrounding hard bony edges of the bicipital groove. This friction leads to micro tears and inflammation of the tendon.
Signs & Symptoms
Soreness on the front of the shoulder when reaching your arm backwards or placing your arm behind your back.
Sore Pain into the front of the shoulder during and after physical activity involving the arm
Stiffness and tightness can be felt in your Neck.
There may be a clicking sensation in the front of shoulder due to AC joint stiffness and poor tracking of biceps tendon in its boney groove.
Pain on lifting the arm upwards from the side or when twisting a Door knob.
Treatment & Management
In the acute stage of the condition, ice coupled with rest from aggravating activities is very important in order to reduce inflammation and allow scar tissue to replace this inflammation. The tendinitis has been arisen in your shoulder due to forward tilting of the humeral head in the shoulder socket due to rounding posture of the shoulders and neck. Manual lifting has served to aggravate this problem. Hence the treatment process should involve treating the tight structures around the shoulder blade which allow the shoulder blade (scapula) and humeral head to assume its neutral position rather than its abnormal forward tilting position that is stressing the biceps tendon. A program of graded strengthening exercises starting with isometric pain free strengthening of the weak bicep tendon are then introduced on a graded basis so as to place progressive tensile load on the newly formed scar tissue of the bicep tendon.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672