Shoulder Pain

Shoulder pain and injury are common. Your shoulder is the most mobile of all your joints. It has to be to allow the freedom of movement for the hand and arm. Therefore is prone to injury more than other joints.

The reason for this movement is a very small joint contact zone. This essentially means that your shoulder is quite unstable and is therefore very reliant on the shoulder rotator cuff  muscles to allow it to work as a normally functioning shoulder.

Like every patient we see, we treat every shoulder on a case by case basis. We specialise in the assessment and rehabilitation of a number of shoulder conditions. These are rotator cuff injuries, adhesive capsulitis (frozen shoulder) or overuse injuries. We also rehabilitate such traumatic injuries as fractures and dislocations or subluxations, by designing personalised rehabilitation programs. We also believe that there is a role for hands on physiotherapy also when treating shoulder conditions to enable recovery. Manual techniques re used to restore normal range of movement of neck, upper back and shoulder region.

• Pain of any nature in or around the shoulder, sharp, dull, deep, aching.
• Dislocation – a feeling of the arm leaving the shoulder joint.
• Subluxation – a feeling of the shoulder popping out then back in again.
• Awareness of instability or weakness in shoulder/
• Any kind of audible ‘pop’ or ‘crack’ sound in the shoulder joint.
• Pins and needles or numbness in the hand or arm.
• Sensation of pain in neck or upper back radiating up from shoulder
• Pain or altered symptoms in the upper back or neck.
• Inability to complete your normal physical activities due to any of the above symptoms.

Rotator cuff pain:

The tendons which control the shoulder movements are called the rotator cuff. These work together to provide strength, stability and movement of the shoulder. However they are prone to damage due to numerous factors. Tears may develop from repetitive motions caused by sports or work movements,  a fall, sudden trauma or an excessive load. These can range from micro tears to full tears or multiple tears. As tendons age they also prone to gradual wear and tear, which predisposes them to injury.

Shoulder impingement

This is an irritation of the tendons as they pass through the space between the top of the humerus (upper arm) and the acromium (boney point on top of your shoulder). These are generally caused by an imbalance in the muscle around the shoulder joint and scapula. This triggers an abnormal movement pattern, which may result in inflammation of the rotator cuff tendons or the bursa in the shoulder joint. This can lead to pain in the shoulder.

Shoulder dislocation

This is a generally caused by a sudden trauma, which causes the humerus to be forcibly removed from your shoulder socket. It can be dislocated anteriorly, inferiorly or posteriorly.

Following a shoulder dislocation a relocation is generally performed in A&E.  The force of the trauma normally results in damage to the labrum (cartilage that is surrounding the shoulder socket) and also the ligaments, which assist in increasing the stability of the joint.

After a dislocation you will generally be placed in a sling. On some occasions you may need to have your shoulder surgically repaired to improve the stability. During your assessment with your physiotherapist we will go through the different stages of rehabilitation. This will be gaining your normal range of motion, slowly increasing the strength and control in your rotator cuff using a personalised rehab program. As we move towards the end of your rehab process we will continually make it very specific to what your goals are so that you return to the activity that you want to.

Frozen shoulder

This is also known as adhesive capsulitis. It is a painful condition which results in the all the shoulder movements becoming progressively restricted. It is a condition that does resolve naturally but it can take a significant amount of time. Physiotherapy plays a vital role in helping progress this painful condition along to the point of regaining normal movement and function of the shoulder.

Some other shoulder injuries that we treat in Dynamic Physiotherapy are:

• Rotator Cuff injuries
• Shoulder Instability
• Frozen Shoulder/Arthritis
• Shoulder Impingement
• Rotator Cuff Tear
• Rotator cuff tendinopathy
• Adhesive Capsulitis
• Bursitis