Shoulder Pain
Shoulder pain is a common and often debilitating injury. The shoulder girdle is made up of a large number of muscles, ligaments, nerves and joints which makes accurate assessment and diagnosis of your shoulder injury crucial to achieving good outcomes.
What causes shoulder pain?
Shoulder pain can be caused by a number of factors, including:
Rotator cuff injury: The rotator cuff is a group of muscles and tendons that help stabilize and move the shoulder joint. Injury to the rotator cuff can cause pain and weakness in the shoulder and in more severe cases prevent you from being able to lift the arm. Rotator cuff strains can be caused by an injury such as falling onto the shoulder or onto an outstretched arm, or from over-straining when lifting something heavy. They also commonly occur with aging, with at least one in three people over the age of 60 having some degree of tearing without any significant associated injury. Rotator cuff injuries are graded by severity according to factors such as size of the tear and whether there is weakness as well as pain. The grade of injury will determine recovery timeframes and the type of rehabilitation required.
Frozen or stiff shoulder: Frozen shoulder is a condition in which the fibrous joint capsule that surrounds the shoulder joint thickens and tightens, causing a stiff and painful shoulder. This condition generally follows an 18- month ‘freezing’ (painful), ‘frozen’ (stiff) and ‘thawing’ (return of mobility) process. Treatment in conjunction with doctors can be of benefit, with options such as hydrodilation helping with pain and stiffness early on. Physiotherapy is most important in the thawing stages of frozen shoulder. A stiff shoulder on the other hand is joint-related stiffening which can be secondary to conditions such as arthritis or injury. This can often be improved with mobilisations and physiotherapist led exercises.
Bursitis: Bursitis is the inflammation of the bursae, small fluid-filled sacs that cushion our joints. Bursitis can be thought of as a blister that fills up with fluid due to friction or rubbing from the surrounding structures. Physiotherapy rehabilitation addresses this by helping change the biomechanics of the shoulder through strength and posture to prevent the friction occurring. Bursitis often presents with pain when lifting your arms above your head, worsening pain at night and inability or increased pain when lying on that shoulder.
Tendinopathy: Tendinopathy is para-inflammation of a tendon which is the part of the muscle that attaches it into bone. Tendinopathy can cause pain and limited range of motion and is irritable when laying on that side at night. It tends to present as a problem after an increase in load or with overuse and is most common over the age of forty. A graded physiotherapy strengthening program is the key to successful rehabilitation.
Arthritis: Osteoarthritis is inflammation that occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates. Symptoms include pain, stiffness, decreased range of motion and popping, clicking or grinding noises in your shoulder joint.
Understanding which structure the pain is coming from, when it occurs and what is driving it allows an accurate diagnosis and subsequent management of your shoulder pain.
How can physiotherapy help manage shoulder pain?
Physiotherapy can help manage shoulder pain in several ways, including:
Accurate diagnosis and education on the condition.
Pain and symptom management: We can use a variety of manual therapy techniques (mobilisations, massage, needling) and biomechanical modification (changing the way you move your body) to reduce pain. This in turn reduces the need for or reliance on medication. It should be noted however that if a medical review is required we will always refer to when necessary.
Graded exercise rehabilitation: Movement is medicine so figuring out how to move safely and what exercises you should be doing in what order is the key. We will work on a range of exercises for flexibility, strength and endurance in the shoulder and surrounding muscles to improve function and reduce pain.
Functional rehabilitation: Ultimately the goal of any rehabilitation program is to get back to doing the things you love as well as the basics that you need for day to day life. We will work with you to create a personalised program that will help you to regain your functional abilities.
Prevention of further injury: A successful physiotherapy rehabilitation program ensures that you are not at risk of repeated or additional injury. Checking that you have dealt with the underlying cause of an injury and then incorporating functional training to reduce reinjury risk is the final stage of rehabilitation.
What can I expect during my physiotherapy treatment?
During your initial assessment, you will receive a comprehensive assessment to determine the drivers of your pain and dysfunction. We will then work through your goals to make a rehabilitation plan. Rehabilitation is always individualised and varies from person to person. Sessions will generally last between 30 and 60 minutes and may include hands-on modalities such as massage or dry needling, as well as education, exercise therapy and functional goal-related rehabilitation. We will closely monitor you throughout the rehabilitation journey, making any changes and adjustments to your rehabilitation plan as necessary.
At Best Physiotherapy, our team provides empathetic, expert care. We understand that shoulder pain can often be frustrating and scary and we pride ourselves on having the skills and knowledge to help you achieve your rehabilitation goals.
Contact us today to learn more about how we can help you manage your shoulder pain and improve your quality of life at Best Physiotherapy, 72 Maribyrnong Street, Footscray
