An osteopathic examination will take into account the broad range of structures which may be contributing to shoulder pain or dysfunction.
After taking a history of the problem the osteopath will perform a postural and range of motion examination, followed by a hands on palpatory assessment of the structures of the shoulder girdle. A working diagnosis of the contributing elements will be arrived at followed by treatment appropriate to the condition and the patient.
The shoulder is a unique area of the body and is termed the shoulder girdle because it is not just one joint but consists of several inter-related joints and muscles. The girdle is defined as the “parts of the musculoskeletal system that link the upper limbs to the sternum in front and to the vertebral column behind, including the sternoclavicular joint, clavicle, acromioclavicular joint, scapula and attached muscles” (1).
The shoulder relies on muscular integrity for its alignment and support and as such muscle stretching, strengthening or conditioning exercises may be prescribed in the treatment plan.
Common Shoulder conditions:
A bursa is a fluid filled sac that normally contains a small amount of synovial fluid and acts as a cushion. A bursa lies between a tendon and either bone or muscle to reduce friction forces and to facilitate smooth movement of adjacent structures. Bursitis is an acute or chronic inflammation of a bursa, which is due to acute or repetitive patterns of movement that put pressure on the bursa and cause it to inflame. Swelling of the bursa in the shoulder is called subacromial bursitis and can present with significant pain and limited mobility (2). Osteopathic manual therapy and Low Level Laser Therapy may help improve bursitis.
Multi-modal management may sometimes be required involving any combination of advice, physical therapy, Laser therapy, corrective exercises for shoulder posture, or in some cases referral for medical management.
*the above is intended to give an overview of the osteopathic approach at our practice, however please note that not all of the above may be offered in one consultation.
- Dictionary of Sport and Exercise Science Medicine. (2008). Shoulder girdle. Retrieved from https://medical-dictionary.thefreedictionary.com/shoulder+girdle
- BMJ Best Practice. (2018). Bursitis. Retrieved from https://bestpractice.bmj.com/topics/en-us/523