SHARE THIS

Dr. Ben Boudreau: Hello, and welcome to another episode of Double Doc Talk. I’m Dr. Ben Boudreau.

Dr. Clayton Roach: And I’m Doctor Clayton Roach. Today we’re talking about shoulder pain. We’re going to be discussing various parts of the shoulder. And I think it will help create a visual of where this pain can come from.

Dr. Ben Boudreau: Absolutely. And we’ll be summarizing this great joint here today.

Dr. Clayton Roach: We brought along someone who didn’t fare well, right? We carved it out of him. Four joints in the shoulder. We can start with the scapulothoracic. This would be like a right shoulder. It would be sitting like this. Right? So scapulothoracic, meaning this is leading on the back. True joint?

Dr. Ben Boudreau: No, no. False. Not a true joint. Yeah, it doesn’t have a synovial lining on the inside, which means it doesn’t have synovial fluid. That is then given to the congruency of the joint. It can’t build pressure.

Dr. Clayton Roach: Yeah. Basically, it’s tied there by muscle laying on top of the shoulder blade, and it will create a glide on that rib cage but not necessarily a joint. So that’s the scapulothoracic, meaning it’s laying on the thoracic spine.

Dr. Ben Boudreau: Absolutely.

Dr. Clayton Roach: The next one will be your C joint, right? Where your clavicle attaches to your sternum.

Dr. Ben Boudreau: Yes. This is a sternoclavicular joint. It’s a great joint. And it attaches your spine to the rest of your body. Your appendicular skeleton to your axial skeleton. And fun fact, this is the only joint in the body that connects the two. And an important anchoring point for that movement of the upper body and the mid back.

Dr. Clayton Roach: Yeah. So like Dr. Ben said, “That’s the only thing that holds your arm to your spine, and it’s going to act like a pivot.” So many times, you know, some hockey players in football can fracture their clavicle, and you can have shoulder problems, neck problems. It just ties both together.

First of all, let’s show them what the acromion is. So this is the thing right here, the little ledge here. And that’s if you tap on the top of the shoulder, that’s the acromion. Right. So basically, that clavicle, the collarbone attaches there. And that’s when that’s the site we talk about, an AC separation. So separation of the shoulder.

Dr. Ben Boudreau: Yeah, exactly. And so these are, people will come in, saying, I separated my shoulder. I separated my shoulder. Yeah. They’re usually not talking about the AC joint. This is where the true separation of the shoulder happens. And most times, this clavicle will dislocate superiorly.

Dr. Clayton Roach: Yeah. So it’s going to pop up.

Dr. Ben Boudreau: It’ll show a big bump. Yeah. On that surface. So that’s the AC joint. Yeah. Moving on.

Dr. Clayton Roach: Yes. Well, hold on. I want to explain that you can develop bone spurs underneath chromium. Often, people will have difficulty raising their arms because this bone here, the humerus, will come jamming right up against that acromion that now has a piece of bone lying there. And sometimes, in some of the surgeries, they do in acromioplasty, they just cut off that bone. So now the arm can clear a little bit of a drastic move. But sometimes you need to do what you need to do.

Dr. Ben Boudreau: Absolutely. So why do they do that to create space for this next joint, the or the Glenohumeral joint? And this is that big joint that everybody knows about in your shoulder. The one that allows you to go all the way up. They all allow you to do that. But this is the one that has the greatest range of motion and the greatest amount of mobility.

Dr. Clayton Roach: Yeah. So that’s the true ball socket joint. There’s the glenoid fossa, and a humerus goes in that allows you to have that range of motion. There’s a nice capsule that keeps it sucked in there. And that’s where we see what’s called a shoulder dislocation. The AC is a separation, and the glenohumeral joint is a dislocation where you see the arm come out and it’s dragging down. That’s going to be your dislocation.

Dr. Ben Boudreau: And most times, these dislocations can happen anteriorly They can happen where the humeral head pops forward, they can happen superiorly where the humeral head is dislocated above the joint, they can happen behind, or they can even happen inferiorly However, the most common way normally if you see a shoulder dislocation, it will be dislocated in front or anterior to the rest of the structures.

Dr. Clayton Roach: Yeah, and anybody who’s had a dislocation before will know that if you try to do this, they’re like, oh no, no, don’t do that because we’re pushing that shoulder forward where it’s been before. And it was painful during the dislocation.

Dr. Ben Boudreau: Because this is one of the most, if not the most, dynamic joints in the whole human body. It can move in various ranges: abduction, lifting, horizontal abduction, and adduction. This joint can internally and externally rotate. It allows you to do a lot of different things in yours. Day-to-day activities.

Dr. Clayton Roach: Absolutely. So those are the four joints that could create shoulder pain. And we’ve got to talk a little about the rotator cuff muscle muscles. I know people get that wrong all the time; rotator cuffs and rotor cuff and rotator cuff muscles can also create shoulder pain. There are four of them. We’ll just briefly go through those. The first one is going to be super speed. Again, this is a right shoulder super spinning this and then the infra spinning. This one here goes through here and attaches to the bone here. Then there are the infra spirits. So those are the two. And then the third one is.

Dr. Ben Boudreau: The subscapularis sits on the front or underneath your shoulder blade. This creates that grip to your third through to your mid back and rib cage. The last one is your terres minor. And terres minor is a great muscle that originates on the bottom of your shoulder blade and attaches to the back of your humerus, to the back of your arm, to allow your muscle to do this.

Dr. Clayton Roach: To summarize, because of the intimate relationship between the shoulder and the neck, many people with shoulder pain can also have some neck issues. And many of these muscles can also relate to or radiate pain down the arm. The shoulder is a site where you can get some shoulder pain, but you need to be evaluated above and below that area to see the causative factors.

Dr. Ben Boudreau: Absolutely. And so, if you enjoyed this, make sure you tune in for other episodes of Double Doc Talk. You can subscribe to us on YouTube from our YouTube channel, or you can give us a follow-on on Facebook, Instagram, and Twitter for more great content. Thank you, guys, so much.

Dr. Clayton Roach: I’m Doctor Clayton Roach.

Dr. Ben Boudreau: And I’m Dr. Ben Boudreau. Have yourselves a great day.