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About Shoulder pain management
shoulder pain Treatment and management
Shoulder pain can be a highly frustrating issue, it can limit your ability to partake in activities you enjoy, whether it is gardening, playing tennis (or pickleball) or whether you have concerns over clicking/ cracking or grinding.
Our approach is to:
1) Identify what may be the cause of your pain
2) Address what is contributing to your symptoms
3) Gain confidence in movement and start building stability and posture awareness around the shoulder and shoulder blade.
Types of Shoulder Pain
Common Types
Of Shoulder Issues
Rotator cuff and bursitis Related Pain
The rotator cuff is the muscles connecting the shoulder to the scapula and they are responsible for movement of the shoulder joint.
As with all areas of the body, sometimes you can have an injury (such as falling on the arm, lifting something heavy or even having a dog tugging on a lead) which can cause trauma or over-loading to these muscles. There can also be elements of over-use with certain jobs or sports and some people can also over-load areas because other body parts are weak. These cumulative or traumatic factors can result in tears, tendonopathy or tendon rupture.
It's important to have a clear picture of the complaint to review whether conservative, surgical or other interventions are most appropriate.
Instability and weakness related pain
Shoulder issues can be a little more complex than other areas of the body, due to the reality that there is often more than one structure involved with a shoulder complaint. There may be an area that's inflamed and area that is compensating which may be causing pain and often areas of weakness that can be contributing to the issue.
The should joint itself is comprised of the bones of the shoulder (glenoid fossa of the scapula and the humeral head), however the bone-to-bone contact is quite small. Most of the shoulders stability comes from the cartilage surrounding and ligaments as well as the musculature holding it together.
The key factor in managing shoulder pain, is strengthening the areas which are contributing to the pain.
acute and sporting related injuries of the shoulder
Shoulder injuries are common in sports, in particular sports requiring a lot of over-head activity (such as swimming/ tennis or throwing sports). Sometimes there can be an initial trauma or knock - such as a bump in football. Or it can be from inadequate loading such as performing high reps or weight on a bench press.
Regardless of cause, there are a range of different complaints and areas which can generate the pain in the shoulder joint. We carefully assess for instability, movement patterns as well as muscular imbalances to give corrective advice. Sometimes with acute shoulder injuries - imaging can be needed and we will guide you through that process.
Potential causes for shoulder pain
Common Causes for Shoulder Pain
The shoulder joint is quite a complex joint of the body. It needs strong stability of muscles to provide support due to the reality it has a large range of movement. In addition, the shoulder is supporting the weight of the arm, against gravity. That combined with its role in performing all your day-to-day tasks means it can be a little vulnerable to injury.
Common factors we see that can contribute to shoulder issues are:
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Over-use related problems:
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Heavy labour jobs
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Repeated movements in your job
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Repetitive overloading from lifting
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Poor lifting technique
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Being sedentary
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History of previous trauma such as fracture, dislocation or tears of cartilage or rotator cuff
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Weakness of the shoulder musculature sometimes from lack of use, or due to sedentary lifestyle
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light pressure or 'stimulus' becomes interpreted as pain.
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Movement patterns which over-load the rotator cuff, while underusing dynamic muscles that hold the shoulder together
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Referral of pain from the neck, thoracic outlet or other structures
Why Seek Treatment
When Should You Seek Treatment For Shoulder Pain?
Typically people seek out treatment for their shoulders due to:
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Weakness in sport
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Pain which is limiting day-to-day function
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Painful clicking, popping or grinding
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Pain when laying on that side in bed
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When you're not sure whether exercises or activities you are doing is helping or aggravating your shoulder
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When you start noticing other muscles getting sore - such as the upper trapezius
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Feeling of instability of the shoulder
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For a check over after an injury
If you are unsure, an assessment can help clarify what's contributing to your symptoms and how to best move forward.
HOW WE MANAGE YOUR COMPLAINT
How We Support Shoulder Pain
Screening And Assessment
We will thoroughly screen your complaint and try to understand why your complaint is there, as well as factors that lead to your symptoms. We then will aim to address whether you have specific goals for us to achieve.
We also will review the history of your shoulder issue, prior procedures, what was effective and what wasn't to guide the next steps in management.
We then will perform strength, range of motion and further special testing to determine limitations as well as movement patterns which might be contributing to your symptoms.
This also lets us assess over time whether treatment is actually helping and whether referral is more sensible.
Manual Therapy Support
There are often times where manual therapy may be useful. We use manual therapy as a tool to assist you in managing the tightness and stiffness that may be contributing to your symptoms. Sometimes in shoulder complaints, the treatment might be focused on improving mobility through the mid-back, ribs as well as the shoulder itself.
We can use techniques such as traction, soft tissue massage, dry needling as well as muscle energy technique and mobilisation where appropriate.
Treatment is variable depending on the issue you have, as well as pain tolerance and associated symptoms.
Education and Exercises
We aim to give you tools to manage your symptoms. Obviously in acute complaints this can be a faster recovery timeframe. Where the complaint is more persistent or has been chronic, then we may require a longer duration of management.
Each shoulder complaint and diagnosis can have different recovery time-frames.
We will also have a discussion with you around your particular needs from management. Whether you are on a time-frame, need to ensure optimal sport performance and we can discuss referral pathways you might need.
When to seek medical attention first
important reasons to visit your doctor for Shoulder pain
Sometimes shoulder pain does require GP or medial assessment. The list below includes reasons to see the GP or seek further medical attention for neck pain first.
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If you have had a dislocation
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If the shoulder is showing a visual deformity
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If you are experiencing shortness of breath
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If you have any pain in the breast tissue, swelling of he arm or pain in the lymph nodes
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If you have any shortness of breath
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If you have had a history or cancer or have noticed any loss of weight, night sweats or deep bone pain
Blog Posts: Shoulder Pain