Shoulders are important; Sir Isaac Newton noted that:
‘If I have seen further, it is by standing on the shoulders of giants’.
For one of us, interest in the subject started at 11 p.m. on 8 April 2006 and can be mostly attributed to Wilson the black Labrador. The recipe for disaster was: killer heels (I had been out for dinner); one supine Wilson enjoying the delights of the Aga; accidental contact between heels and Wilson; a large dose of Newton's laws; a misguided attempt to interfere with Newton on my part. I've gone off Newton and the shoulder still hurts (Wilson, however, thrives).
Shoulder problems are responsible for significant levels of morbidity and disability, the prevalence in the general population is about 7% (though rising to 26% in the elderly). Most people with shoulder pain don't consult their GP, when they do the GP diagnostic vocabulary is a bit limited and vague. Outcomes are not impressive, with half still bothered by their symptoms after 1–2 years,1 added to which the best evidence we have about effectiveness of interventions is related to what doesn't work.
This month's deceptively simple Top Tips in 2 minutes on shoulder pain should help you see further; having read it, you will be able to distinguish between rotator cuff syndrome and adhesive capsulitis, which are the commonest cause of shoulder pain.
However, the important research question must surely be: do shoulder pads, like hip pads, prevent injury? Answers on a postcard please.
Top Tips in 2 minutes: Sorting out shoulder pain.
Acknowledgments
Thanks to Addenbrookes postgraduate medical centre for advice, support and good humour.
- © British Journal of General Practice, 2008.