Shoulder Girdle

Adhesive capsulitis is a condition in which the connective tissues of the shoulder joint become inflamed and fibrotic, leading to a progressive stiffening of the joint capsule. It often develops gradually over weeks to months in people aged 40–60, especially those with diabetes or thyroid disorders, and is marked by a restricted range of motion in all directions.

Typically you’ll notice a deep, aching pain that is worse at night and an increasing inability to lift your arm to the side or rotate it outwards. Sleeping on the affected side becomes uncomfortable, and simple tasks—such as fastening a seatbelt, brushing your hair or reaching into a cupboard—are met with a sharp catch or dragging sensation in the shoulder.

Rotator-cuff tendinopathy refers to degeneration, accompanied with inflammation, of the tendons that stabilise the shoulder—most commonly the supraspinatus—while tears involve partial or full-thickness disruption of these fibres. This spectrum of injury arises from chronic overuse, impingement or sudden overload, and is most frequently seen in adults over 40.

You’ll often feel a throbbing or sharp pain on the outside of the shoulder, particularly when lifting your arm between 60° and 120° (the “painful arc”). Weakness or an inability to maintain arm elevation, especially when turning the arm outwards, plus disturbed sleep from lying on that side, are hallmark signs.

Bicipital tendonitis is inflammation of the long or short head insertions of the biceps tendon at the front of the shoulder. It typically develops in those who perform repetitive lifting or overhead movements, such as manual workers and athletes.

Recognition relies on a pinpoint ache or sharp pain in the anterior shoulder, often centred in the bicipital groove, just below the collarbone. Actions that involve resisted elbow flexion or forearm supination (twisting)—like lifting a mug or turning a doorknob—tend to exacerbate the discomfort, and pressing into the groove reproduces the tenderness.

Subacromial bursitis occurs when the bursa that cushions the rotator-cuff tendons beneath the acromion process of the shoulder blade becomes inflamed and swollen. This often accompanies rotator cuff impingement or follows direct trauma to the shoulder region.

You’ll notice a sharp, localised pain beneath the tip of the shoulder when lifting the arm outwards or overhead, often accompanied by a subtle crepitus as the bursa rubs against the bone. Tenderness just below the lateral/outer edge of the acromion (the point of the shoulder)and intolerance of lying on the affected side are classic indicators.

Glenohumeral osteoarthritis is the degenerative loss of cartilage within the ball & socket aspect of the shoulder joint combined with bony spur (osteophyte) formation, most commonly affecting people over 55 or those with a history of shoulder trauma.

This presents as a deep, grinding ache that worsens with movement, particularly external rotation and lifting the arm sideways. You may experience a catching or clicking sensation (crepitus), alongside stiffness that is most pronounced on first rising in the morning but often eases within 30 minutes.

AC joint dysfunction encompasses both osteoarthritic changes of the acromioclavicular joint and ligament sprain or separation following trauma. It affects the small joint at the top of the shoulder where the collarbone meets the acromion of the scapula (shoulder blade).

Features include localised pain at the very top of the shoulder that intensifies when you cross your arm across the chest—such as when fastening a seatbelt—or lifting objects laterally. A palpable bump or “step” at the end of the collarbone and tenderness over the joint line will often be seen.