Shoulder pain occurs when the shoulder joint or the surrounding muscles, ligaments and tendons gets injured. The pain can occur in the anterior as well as posterior side of the shoulder but the anterior shoulder pain has been found to be more common among individuals. The Anterior shoulder pain usually develops when injury or inflammation occurs in the tendons that are attached to the shoulder joint. In this condition the rotator cuff is unable to support the glenohumeral joint thereby causing pain in the biceps and the shoulder.
What is Anterior Shoulder Pain and Where Does It Happen?
The human shoulder is made up of a combination of several bones and tissues that surround these bones. The bones that make up the shoulder are humerus, glenoid, scapular, acromion and clavicle. These bones together with muscles and tendons form the shoulder joint.
The rotator cuff helps in supporting the shoulder joint and allows the movement in the arm. Since, rotator cuff is a structure made of muscle and tendons, these tendons when get injured or inflamed contribute to anterior shoulder pain.
Shoulder pain is a common pain encountered by people around the world. It is a pain which is age independent and hampers the mobility of the arm. The common anterior shoulder pains are:-
- Rotator Cuff Tear/Tendinophathhy: It results in weakening of tendons with severe pain in external rotation.
- Adhesive Capsulitis: Stiffness in the shoulder joint leading to loss of movement in case of abduction and external rotation.
- Acromioclavicular Joint Injury: Pain is localized over the clavicle due to overuse of the shoulder.
- Biceps Tendonitis: Pain is caused due to lifting up and carrying heavy objects.
- Impingement Syndrome: In this condition, the shoulder pain occurs due to rubbing of tendons on the shoulder blade.
- Labral Tears: The cartilage in the shoulder region is torn resulting in severe and deep pain.
Symptoms of Anterior Shoulder Pain
The symptoms of anterior shoulder pain are:-
- Swelling and tenderness in the anterior region of the shoulder.
- Severe pain
- Continuous sense of discomfort
- Inability in lifting of objects
- Hindrance faced when lowering the arm
- Decreased strength of the arm
- Limiting in the movement of arm.
Causes of Anterior Shoulder Pain
The anterior shoulder pain is commonly caused by shoulder injuries such as fractures due to bone breakage or injured tendons and muscles. The anterior shoulder pain could also be due to repetitive strain of the muscles or overhead activities. Furthermore presence of a prior health condition leading to sore shoulder can also result in anterior shoulder pain.
Diagnosis of Anterior Shoulder Pain
The primary diagnosis of anterior shoulder pain includes physical examination to check for the appearance of signs and symptoms of anterior shoulder pain. Furthermore, X-Ray can be done to check for clear image and condition of the shoulder.
There are also certain physical tests that are done to check for the range of movement and extent of severity due to shoulder pain. Some of these tests are Rowe Test, Surprise/Release Test, Dynamic Relocation Test, Dynamic Rotatory stability test, kinetic medial rotation test etc.
Treatment of Anterior Shoulder Pain
The aim of the treatment for anterior shoulder pain is reducing the swelling, pain and increasing the range of the motion of the affected shoulder. The methods followed for doing so are:
- Medication to Treat Anterior Shoulder Pain: The doctors may prescribe general anesthesia or muscle relaxants to reduce the pain in the shoulder joint. Some of the pain relievers are ibuprofen, aspirin, acetaminophen etc.
- Cold Therapy as a Treatment for Anterior Shoulder Pain: It uses ice or cold treatment to relieve pain and reduce the swelling. The application of cold should be done for at least 10 to 15 minutes at an interval of two to three hours.
- Surgery to Treat Anterior Shoulder Pain: These are done in the cases where there is a sustained issue of shoulder dislocation for multiple times owing to the persistent instability within the shoulder. The surgery aims at helping the patient in regaining the strength of the shoulder and providing full range motion.
Exercise of Anterior Shoulder Pain
The exercise to reduce the shoulder anterior pain includes three kinds of exercises which are range of motion exercises, stretching exercises and strengthening exercises. These exercises should be done under the supervision of a trained professional, only after the advice of doctors. One must ensure that these should be done only after the recovery from the injury.
- Range of Motion Exercises for Anterior Shoulder Pain: These exercises ensure that the shoulder joints are moved in different directions, so that the joint could achieve a full range of motion. These exercises help the joints to become more flexible, with improved sense of balance and strength. Thus, these contribute greatly in reduction of the shoulder pain. The commonly followed ranges of motion exercises are pendulum and flexion.
- Stretching Exercises for Anterior Shoulder Pain: These exercises are done to focus especially on the tendons of the shoulder region. The exercises help in improving the flexibility and elasticity of tendons by deliberately stretching the muscles and tendons. This in turn further improves the range of motion of the shoulder joint along with increased muscle control. The commonly performed stretching exercises are seating and standing flexion, and external rotation.
- Strengthening Exercises for Anterior Shoulder Pain: These are also known as strength training, in which the physical exercise utilizes resistance to build up muscle strength and size. This in turn helps in the stability of the shoulder. These exercises should be done only on the advice of medical practitioner as well as it should be done after recovery. The exercises are known to cause muscle fatigue and soreness, hence if they are done during the presence of pain then the condition may get worse to a great extent. The general strengthening exercises include scapular depression and adduction, shoulder flexion, internal rotations, external rotations, scapular protractions, scapular retractions and shoulder extensions.
Prevention of Anterior Shoulder Pain
The common practices that can be followed in order to prevent anterior shoulder pain are:-
- Ensure proper strength, flexibility and fitness
- Performing warm up and stretching exercises before the normal activity.
- Taking ample recovery time between the workouts.
- Ensure to follow proper exercise technique, under the guidance of trained professional.
- Using protective gear and equipment while exercising.
Pain in the anterior region of the shoulder is the most common type of shoulder pain encountered. It can result due to various factors which contribute to the inflammation and injury to the rotator cuff and the tendons. This condition greatly hinders the normal functioning of hand like inability to lift objects, to raise the arm or to rotate the same due to continuous sense of pain, swelling, discomfort and stiffness. Anterior shoulder pain can also arise due to some prior chronic health issues. Pain killers can be taken to immediately address the pain. The other measures to cure the condition are exercising, cold compression and heat therapy. For severe cases, surgical measures can be opted to restore the normal range of motion of the shoulder. The precautionary measures should be followed in order to avoid the occurrence of the anterior shoulder pain which includes regular exercising along with warm up and stretching exercises by taking professional help and taking ample amount of rest.