Are you experiencing shoulder pain? Our physiotherapist Jason discusses the cause and symptoms of shoulder pain/injuries and highlights what our physiotherapists can do for you in terms of treatment.
Why do I get shoulder pain?
Shoulder pain and injuries greatly vary from person to person. Anatomically, the shoulder has very poor joint contact or congruence. A good analogy is to think about the shoulder like a golf ball and golf tee. This is great as the shoulder can move in a variety of different directions, however it also means that the shoulder is inherently unstable.
Shoulder injuries can occur following a specific incident or they can happen gradually over time.
The most common shoulder injuries include:
- Rotator cuff injuries. One of the most common causes of thus is due to poor muscle strength and endurance of the rotator cuff. This can also be caused by other injuries such as rotator cuff tears, rotator cuff tendonitis, and shoulder impingement.
- Frozen shoulder. Frozen shoulder can result in chronic shoulder pain and stiffness, which gradually deteriorates until the shoulder movement is very limited.
- Dislocated or subluxed shoulder. This occurs at the shoulder when the ball and socket is separated.
- Ligament. Ligament injuries of the shoulder can occur when ligaments between the collarbone and the shoulder blade have been torn or overstretched.
- Arthritis. This occurs when the cartilage of the shoulder joint starts to wear down.
Symptoms of shoulder injuries:
Depending on the nature of your shoulder pain, shoulder symptoms can be varied. Our team recommends getting in touch with your physiotherapist if you experience any of the following signs or symptoms.
- Pain in or around the shoulder. This could vary from sharp pain, dull ache to a deeper aching pain.
- Any additional noises such as a ‘pop’ or ‘crack’ sound in the shoulder joint.
- This often results from a specific incident in which the joint displaces causing a feeling of the arm ‘separating’ from the shoulder joint.
- Subluxation – a feeling of instability around the shoulder with the shoulder commonly popping out and then back in again.
- Altered sensations in upper limbs. This can include pins and needles or any numbness in the hand.
- Pain radiating up into the neck or upper back region.
- Weakness around the shoulder.
- Inability to complete your normal physical activities.
How can physiotherapy help with a shoulder pain?
Identifying and diagnosing the likely cause of your shoulder pain is the first step in reducing pain and rehabilitation of shoulder pain.
Your physiotherapist is highly trained to diagnose and identify the likely factors of your shoulder pain or injury and will begin by asking a range of questions. These questions will focus on the location and type of pain, mechanism of injury, what makes the symptoms better or worse and what your personal goals and aims may be.
Following an assessment, your physio will perform safe and non-invasive flexibility and strength tests to identify where the symptoms are felt.
In some cases, especially following trauma such as a contact type injury or dislocation, your physio may refer for ongoing imaging such as an X-ray or MRI. However, in the majority of cases where symptoms have gradually come on, further imaging or tests are usually not warranted.
After making a diagnosis, your physio will develop a treatment plan to reduce pain and return you to your normal activity as quickly as possible. Your physio will also develop an individualised and specific strengthening and rehabilitation program to assist your recovery.
Hands on treatment is also important for recovery and rehabilitation of shoulder pain. Manual techniques can play an important role in restoring normal movement through your neck, back and shoulder.
Common exercises for shoulder pain
Exercises for shoulder pain commonly focus on improving the rotator cuff and stability muscles around the shoulder blade. Theraband and resistance bands are useful in the treatment of shoulder pain.
Isometric external rotation
A great exercise to perform in the early stages of shoulder pain which is caused by impingement involve are isometric exercises. Tie your theraband to a door handle or wedge the band into the door. Keeping your elbow tucked in and elbow at 90 degrees, step away from the door. Hold for 10 seconds.
External rotation with a theraband
Advancing of the previous exercise. Keeping your elbow tucked in, slowly rotate your forearm away from your body. A good tip is to ensure your thumb is pointed up towards the roof.
The mid back or thoracic spine can commonly affect shoulder mobility. This is because reduced back flexibility can often affect movement of the shoulder blade.