Shoulder pain is a common affliction that affects many people on a daily basis. Depending on the severity of the pain this type of problem can have a significant, negative impact on performing your occupation and your activities of daily living. There are several ways that shoulder pain can develop and I will discuss those below.

The most recognized way for pain to develop in the shoulder is through trauma. This could consist of something obvious like falling onto your outstretched arm causing your shoulder to jam or trying to push or pull on a stuck object. A less obvious traumatic event could be forcefully using the muscles of the shoulder over time and then pain occurs. This could happen during activities such as chopping firewood, hammering, or exercising in a repetitive fashion. The first traumatic event is identified as a macrotrauma meaning it's a large and obvious event. The second situation is termed a microtrauma meaning it's less obvious and occurred with repetitive insults to the muscle tissue. One does not necessarily occur more than the other, but both can cause significant injury and pain.

The macrotraumatic event can lead to injury of the muscle by causing a major tear in the muscle fibers. A muscle tear is exactly what it sounds like. The muscle fibers actually rip apart and become separated from each other or where the muscle tendon inserts on a bone in the shoulder. You can have different size tears and these are usually termed partial, full or full thickness tears. It is important to remember that just because a muscle tear is present that doesn't always mean you will have to have surgery. Signs that a shoulder muscle is torn include but are not limited to pain, weakness, and loss of motion.

A microtraumatic event or repetitive overuse can lead to injury of the muscle by causing minor tears in the muscle fibers. These are small in degree but enough to cause an inflammatory process to occur which leads to pain. This is a condition that we would commonly term as tendonitis (an inflammation of the muscle or tendon). It is not the same as a partial or full tear. The muscle fibers do not actually separate from each other. This type of event can cause significant pain and dysfunction. Signs that a shoulder muscle is inflamed include but are not limited to pain, weakness, and loss of motion.

Another common cause of shoulder pain is bursitis. A bursa is a fluid filled sack that sits between muscle and bone. The bursa is designed to protect the muscle from scraping against the bone, thus it protects it from becoming irritated against the bone. The bursa has a lot of nerve endings in it. If the bursa becomes inflamed we term this bursitis and it can be very painful. A bursitis can occur in the shoulder as the result of a macro or microtraumatic event as described above just like a muscle tear or tendonitis can develop. Signs that a shoulder bursa is inflamed include but are not limited to pain, weakness, and loss of motion.

These are three of the most common pathologies that cause pain in the shoulder. You will notice that the symptoms that you may experience as a result of these conditions are very similar. So how do you tell which problem you may have? Well, to determine that you should consult a competent Physical Therapist in your area that specializes in the evaluation and treatment of musculoskeletal and/or orthopedic pathologies. They will be able to successfully diagnose the source of your pain and treat the problem appropriately.