Optimal shoulder function is essential to minimise the likelihood of injury during everyday use of the arm and for those involved in sports using the upper body, such as racquet sports or those that involve throwing objects. Pain may be caused by local structures within or around the shoulder, or may be referred from other sources (such as the neck or upper back).
One common clinical presentation is the patient suffering from the sudden onset of shoulder pain, typically as a result of lifting, pushing or pulling something, or of a sudden movement (often with the arm in elevation or overhead), which can often result in a torn muscle or tendon, usually a rotator cuff tear. In patients with gradual onset shoulder pain due to repetitive or prolonged arm elevation, lifting, pushing or pulling activities, general housework or lying on the affected side, rotator cuff tendonitis is the more likely diagnosis, which typically involves gradual degeneration and inflammation of the rotator cuff tendons. In those patients with associated neck, upper back, elbow, forearm, wrist or hand pain, referred pain (frequently from the neck or upper back) is often the cause of the symptoms. There are numerous other causes of shoulder pain, some of which present suddenly due to a specific incident and others which develop gradually over time.
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