A SIMPLE UNCOMPLICATED APPROACH for a COMMON PROBLEM – Shoulder Pain
The shoulder is the most mobile joint in your body allowing you to move your arm freely in many different directions:
- Raise your arms over your head
- Scratch your back
- Put your wallet in your back pocket
- Throw a ball
But, unfortunately, this mobility makes the shoulder vulnerable to injury and we rely on team work from all the muscles around the shoulder, neck and trunk to keep us moving well and injury free.
Why your shoulder might hurt
- Repetitive action can lead to tissue overload.
- A sedentary lifestyle, with a lack of big arm movements, compromises the flexibility and strength of the soft tissues and muscles around the shoulder.
THE ROTATOR CUFF
The Rotator Cuff is a name given to a group of 4 muscles whose tendons attach to the bones of the shoulder joint. Their role is to keep the ball of the upper arm bone centred in the shoulder socket which helps us move our arm in many directions strongly and without discomfort.
Rotator cuff related shoulder pain
- Frequently shoulder pain is given a diagnosis related to the rotator cuff tendons or adjacent tissues:
rotator cuff tendinopathy
- subacromial impingement syndrome
- subacromial bursitis
- partial and full thickness rotator cuff tears
These conditions are often based on a diagnosis from imaging, however scan results are not always helpful in directing management of shoulder pain.
Degenerative tears can trigger shoulder pain but are also common findings in pain free shoulders. Often you won’t even be aware of these tears, as some are completely asymptomatic and cause no problems.
GRADUATED EXERCISE IS THE VERY BEST TREATMENT
- Restore full natural movements and strengthen your shoulder muscles Progressing load is an important factor for strength training Exercises must prepare you to be able to perform the shoulder movements you need to do and with the desired skill and maximum effort
- Restore full natural movements and strengthen your shoulder muscles
Progressing load is an important factor for strength training
- Exercises must prepare you to be able to perform the shoulder movements you need to do and with the desired skill and maximum effort
IF YOUR SHOULDER PAIN DOES NOT RESPOND TO EXERCISE?
DON’T DESPAIR – Sometimes your shoulder pain may be slow to respond or you may not be able to start a successful exercise program, but view this as a hurdle rather than a failure.
Manual therapy is a useful tool to change the load on the shoulder tissues to enable you to start a graduated rehabilitation program. If pain persists, extracorporeal shock wave therapy (ESWT) may give some pain relief and allow you to start to strengthen your muscles.
The trunk provides the supportive platform to enable the necessary muscle activity for the shoulder to move freely and push, pull or lift strongly. If you cannot move freely through your trunk, the shoulder muscles may be compensating which will potentially impact shoulder function.
Surgery or Exercise?
Surgery is not necessarily the best or most appropriate approach for treatment for non-traumatic shoulder pain and research shows there is an equal or greater chance of getting better with conservative management.