Disorders of the shoulder are common and often disabling. They affect all age groups but are particularly common in individuals who are active in sport, and in work or recreation that involves overhead activities. The clinical tests and imaging modalities used to diagnose shoulder pain have advanced significantly, as have methods to treat shoulder problems. Fortunately, we are moving out of the era of a “black box” for shoulder pain into an era where the condition can be diagnosed specifically and treated rapidly and effectively.

Major conditions affecting the shoulder

There are actually relatively few diagnoses to make when considering shoulder dysfunction. The shoulder can be too loose – (shoulder instability) or too stiff (frozen shoulder), the rotator cuff can dysfunction or there may be a fracture or arthritis. These disorders account for over 95% of all shoulder conditions (Table 1).

Table 1
Problem Structure Age group
Instability Labrum-capsule 17-30
Stiffness Capsule 40-60
Impingement Rotator cuff fatigue 30-60
Rotator cuff tear Rotator cuff especially supraspinatus 50+
AC joint pain AC joint cartilage 20-40
Arthritis Gleno-humeral joint cartilage 70+