Are you suffering with shoulder pain that is making life difficult? Is it painful when you lift your arm, carry weights or shopping or does it wake you up at night?
If so Physiotherapy with one of our experienced practitioners will help get you back to your normal activities so don’t suffer in pain any longer.
Physiotherapy treatment is essential in the early stages of shoulder pain to prevent the condition becoming more complex and difficult to resolve. So don’t delay in booking a physiotherapy appointment for an in-depth diagnosis and treatment plan.
We regularly see patients requiring shoulder pain treatment to help their pain and to get the movement back to normal.
The shoulder is a joint that is vulnerable to injury and excessive wear due to its enormous range of movement. It is also difficult to rest or achieve some pain relief as gravity pulls the arm down whatever you are doing and you may also lie on it at night causing more pressure and pain! It may be preventing you reach your potential in the gym or just making everyday tasks painful and difficult.
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‘I thought it would get better on its own’ is something we often hear when someone comes to physiotherapy with a shoulder problem. Unfortunately the problem often continues without some intervention and treatment.
Without targeted shoulder treatment from the physio the problem can quickly become more complicated with rapid loss of muscle strength and stability around the shoulder and shoulder blade. This can cause secondary problems such as neck pain, headaches or a frozen shoulder.
Initial physiotherapy sessions focus on reducing the pain and stress on the damaged tissues using techniques such as taping, massage, mobilising the joint, exercises and advice for you to take home to encourage healing and prevent aggravating the condition further.
The reason so many changes are possible after a shoulder injury is due to the way the joint is held in place. Unlike the hip which is a secure ball and socket joint, the shoulder is a very lax, shallow joint and relies more on muscles and other ‘soft’ tissues to keep it in the correct position. When there is pain or disruption to the joint those important muscles become weaker due to lack of use and pain and the whole joint is no longer properly supported.
Once the initial shoulder pain treatment has helped the injury heal and the shoulder is more comfortable then it is time to work on any stiffness and weakness that has developed to get the shoulder moving and working correctly at whatever level of exercise you do. Otherwise, even if the pain resolves the shoulder is very vulnerable to further injury or over use.
Just to make matters more complicated problems in the neck (cervical spine) can often refer pain into the shoulder as they share many muscles and the path of many nerves from the neck all pass through the shoulder.
Also a shoulder problem is often felt only in the upper arm and not in the shoulder area at all!
So it is vital the physiotherapist conducts an extensive and thorough examination of the neck, shoulder and arm to diagnose exactly where the problem originates from. They can then treat the condition, not just the symptoms to achieve a full and long term recovery.
A frozen shoulder is often the diagnosis given to anyone with stiff shoulder pain but it is a specific condition.
A full assessment by an experienced physiotherapist is therefore vital to confirm whether or not this is the problem so the correct shoulder pain treatment and advice is available.
Shoulder Pain Treatment due to a frozen shoulder.
Physiotherapy can help by reducing the pain, gently stretching and mobilising some of the tissues around the joint and helping you with some exercises. Your physiotherapist may also use acupuncture and specialised taping techniques to reduce pain and support the delicate muscles around the shoulder and neck.
Pain can often spread into the neck, shoulder blade, arm and hand because the shoulder is not being used properly. We can help with the pain and tightness in those areas too.
It can occur anytime for no apparent reason but is more common if you are:
The capsule around the shoulder joint becomes thickened and inflamed and this quickly develops into severe stiffness and shoulder pain. Moving the arm into normal positions is impossible-even if someone else tries to help. The joint is stuck.
If left untreated the condition can naturally resolve but this usually takes 2-3 years.
Every time we raise our arm above our head or behind our back we squash certain structures between the arch of bone made by the scapula and the head of the humerus (top of the arm).
This includes tendons of muscles that move our arm in specific directions.
As the squashed tissues become inflamed and therefore enlarged the problem worsens as the space they have to move in is further reduced. Shoulders can stiffen and weaken quite quickly so early shoulder pain treatment is vital to sort the impingement and prevent further problems. Painkillers and rest can help but patients often tell us that they have rested it for weeks but as soon as they move the arm properly again the pain returns.
Shoulder Pain Treatment for impingement
Correct, early advice is vital so further damage is prevented. No pain no gain is NOT something we apply to shoulder problems. They can become very sore and inflamed if the condition is constantly irritated.
As well as advising you what you should and should not do us will initially reduce the pain with soft tissue techniques and possibly acupuncture. We may support the shoulder with taping techniques.
We will give you some exercises to try and keep the shoulder as strong and mobile as possible without irritating the sore structures.
Pain can often spread into the neck, shoulder blade, arm and hand because the shoulder is not being used properly. We can help with the pain and tightness in those areas too
Once the pain and inflammation is resolved we will look at why the problem may have occurred and modify how you work or exercise to prevent a re-occurrence.
Specialised stabilising exercise will help position the shoulder correctly so reducing the pressure on the injured tissues in the future.
As the shoulder is a very unstable joint it relies more on the muscles around it to support it and stabilise it. This job is done partly by the rotator cuff muscles. There are four:
Each muscle performs a particular movement of the shoulder so assessment can isolate which one is causing the problem
Shoulder Pain Treatment for a rotator cuff injury
Your physiotherapy will assess you to diagnose which muscle is injured and how severely.
As well as advising you what you should and should not do. We will initially reduce the pain with soft tissue techniques and possibly acupuncture. We may support the shoulder with taping techniques.
We will give you some exercises to try and keep the shoulder as strong and mobile as possible whilst allowing the injured muscle to heal.
Once healing is underway you will be shown specific exercises to strengthen the injured muscle. Stability exercises may be used to strengthen the larger muscles of the shoulder girdle around your shoulder blade which will put less stress on these smaller rotator muscles and reduce the chance of further injury.
Pain can often spread into the neck, shoulder blade, arm and hand because the arm is not being used properly. We can help with the pain and tightness in those areas too
If you need to return to a sport then your movement patterns will be analysed and specific rehabilitation exercises given to correct any faults.
As we said previously it is not usually the bones and joint of the shoulder that cause problems. However there are some conditions that affect the joint itself.
The more common type of arthritis, osteoarthritis does not normally affect the shoulder joint as much as other joints.
Rheumatoid arthritis however which is an auto- immune problem does often affect the shoulder joint. Sufferers are usually under the care of a rheumatologist as it is a severe and debilitating condition. Physiotherapy can help with the pain and when appropriate the range of movement. The neck is also often affected and can be treated too.
A fall onto the tip of the shoulder may result in a break or fracture.
Severe or complicated breaks may be treated with surgery using internal metalwork in the joint. Otherwise rest in a sling is the only alternative to prevent the bones moving and allow healing. It is not possible to put a cast around the shoulder.
Resting the shoulder even for a short time causes stiffness and tightness and this has to be addressed once the fracture is healed and movement is allowed.
However, whilst the bones are healing there are things you can do to keep the muscles around the shoulder as strong as possible. This will make rehabilitation quicker and easier once the rest period is over.
We are therefore able to offer some treatment even whilst the shoulder is being rested to reduce the pain and optimise your recovery without compromising the healing.
Once safe we can treat with massage, joint mobilisation and exercises to continue helping the pain and healing and increase the strength and movement.
Contact our Lewisham clinic based at Anytime
Fitness Birdwood Avenue Lewisham SE13 6UR.
Visit our physiotherapists based at our Leyton clinic -
300 High Road, Leyton, E10 5PW.
Find us at 36 Eastern
Esplanade, Southend, Essex, SS1 2ES.