Physiotherapy treatment for shoulder pain
The shoulder is one of the most complex joints in the body. It is designed for mobility and is heavily reliant on the structures around the joint to enable it to perform at 100%. Shoulder pain is amongst the top three most common reasons that people visit physiotherapists and rotator cuff injuries are responsible for many of these shoulder problems.
The most common causes of shoulder pain are osteo-arthritis, impingement (pinching and inflammation of the soft tissues in the shoulder), tears or damage to the rotator cuff muscles or tendons and instability as a result of or possibly leading to a risk of dislocation. We also see people for physiotherapy after shoulder fractures, shoulder replacement, tendon and muscle repairs, decompression or other shoulder surgeries.
The most common shoulder injuries:
Rotator cuff injuries - Common causes are overuse or repetitive movements, weakness and imbalance of the shoulder muscles and trauma. These can lead to muscle tears, tendon damage and impingement or compression of the tendons. The rotator cuff muscles attach around and stabilise the shoulder joint and their strength and balance is very important for shoulder health.
Subacromial impingement - Pinching of the bursa and tendons underneath the bony arch at the tip of the shoulder. These structures then become swollen and inflamed.
Shoulder tendinopathy - damage to the shoulder tendons, usually the rotator cuff or biceps tendons. This can cause pain affecting the neck, upper arm and shoulder, restrict range of movement and make lifting or lying on the arm painful.
Frozen shoulder - A gradually increasing pain, usually coming on without trauma, leading ultimately to extreme stiffness in the shoulder.
Dislocated shoulder - Occurs when the shoulder ball and socket joint is separated. It is also possible to dislocate the acromio-clavicular joint where the collar bone and shoulder blade meet at the tip of the shoulder.
Ligament injuries – These occur with trauma when ligaments between the collarbone and the shoulder blade at the tip of the shoulder (the acromio-clavicular joint) have been torn or overstretched, or when the ball and socket joint of the shoulder has been overstretched or dislocated.
Arthritis - Where the cartilage of the shoulder joint starts to wear down, causing inflammation and pain.
Can physiotherapy help shoulder pain?
We may not notice how often we need to raise our arms during daily living until it hurts to do so or it hurts to lie on the affected side. Many shoulder problems appear to come on spontaneously without any trauma to the joint. In the majority of cases of shoulder pain, physiotherapy will be able to provide relief.
Identifying and diagnosing the likely cause of shoulder pain is the first step to reducing symptoms and to introducing the right type of rehabilitation. After diagnosis, physiotherapists will develop a treatment plan to help reduce pain and restore muscle strength and control and help return patients to normal activity as quickly as possible. This will always include an individualised and specific strengthening and rehabilitation exercise program to assist recovery. We can also refer where appropriate for ultrasound scanning, injection therapy, MRI and surgical opinion.
Hands on physiotherapy treatments combined with exercise programmes play an important role in restoring normal movement through your neck, back and shoulder. For chronic shoulder tendinopathy, an effective non-surgical and non-invasive treatment is shockwave therapy. Shockwave therapy works to help re-establish a healing process when an injury reaches a chronic non-healing state.
For further information on any of the treatments mentioned in this article, or to discuss treatment for your shoulder pain, please contact Cotswold Physiotherapy on 01993 201485 or send your enquiry here