The shoulder joint is often thought of as complex and difficult to treat, however getting a great outcome, including reducing pain, improving the function of your shoulder and allowing you to return to doing all you love, doesn’t need to be.
Types of shoulder injuries we treat
At Thrive Physio Plus we treat a wide variety of shoulder injuries. These include but are not limited to the following:
- Rotator cuff tears
- Rotator cuff pathology
- Shoulder ‘impingement’
- Shoulder bursitis
- Rotator cuff tendon issues
- Frozen shoulder/Adhesive Capsulitis
- Shoulder instability issues including a history of a dislocated shoulder or subluxation
- Shoulder dislocation
- Degenerative shoulder issues including shoulder osteoarthritis
- Post-operative shoulder issues including rehabilitation
- Overuse injuries
Underpinning the diagnosis of shoulder pain by a shoulder physiotherapist is a thorough process of information gathering. In particular, what makes your symptoms worse or better, how your symptoms started, the type of symptoms you’re experiencing, whether there was a history of trauma or not, as well as your age and general health status amongst other things.
Questions such as these allow us to develop a list of hypotheses, seeking to rule these in or out on our physical examination. They also allow us to rule out the possibility of anything sinister being the cause of your pain, for which we might need to further investigate prior to us treating your shoulder appropriately.
Our physios will also seek to rule out other conditions that can masquerade as shoulder pain, for example, your neck can sometimes refer pain into your shoulder. You can read more about this condition here.
When attempting to diagnose shoulder pain, trying to pinpoint the exact structure (e.g. the shoulder joint) is impossible and unnecessary. Anyone who tells you otherwise is lying! Outside of sinister causes like cancer and a few other select conditions (dislocation in the young population, not so much the elderly for example), we classify shoulders under three categories:
- Weak and painful
- Stiff and painful
For all cases, physiotherapy has been shown to be extremely effective. The other benefit of seeing a local shoulder physiotherapist is that for cases that require specialist intervention as part of a treatment plan, we’re experts in our assessment for recognising this and can refer you on as needed.
As in many musculoskeletal presentations, treatment involves a combination of the following:
Education and Advice:
The research shows expectations guide your outcomes. The more you understand your condition and feel optimistic about your recovery, the better the outcome you’ll achieve.
It also allows you to feel in control of the process, so you don’t just feel like you’re along for the ride.
Hands on Therapy:
This can include a combination of shoulder joint mobilisation, soft tissue massage, and or dry needling. Shown to relieve pain for 24-48 hours, it’s a good adjunct to treatment but won’t be the thing that gets you better in the long term.
Part of the reason shoulder pain can be so intense is due to the structures of your shoulder, often the muscles, becoming overworked and irritated. By reducing the sensitivity of these issues with the aforementioned techniques, it can be very effective in relieving pain for a short period of time.
Physiotherapy Exercise for Shoulder Pain relief:
Considered a first-line treatment for musculoskeletal pain, this is where getting the long-term outcome you’re seeking lies. It helps both in reducing discomfort in the short term whilst improving function, quality of life and reducing disability in the long term and making sure your pain doesn’t return.
Is Physiotherapy good for shoulder pain?
Yes, physiotherapy is research-proven to reduce pain and improve function and quality of life.
What does a physio do for shoulder pain?
Perhaps most importantly, they can give you clarity. Clarity about what you should or shouldn’t do, the likely cause of your shoulder pain and the contributing factors, a timeframe for recovery and what a step by step treatment plan will look like.
They can also look to rule out sinister pathology or refer appropriately to put your mind at ease. Beyond that, it really depends on the person, as well as the presentation. For acute cases, hands-on therapy as mentioned above can be useful as an adjunct to exercise in achieving a great outcome.
For more long term shoulder pain, great advice, information and rehabilitation that involves working on improving the muscle strength of your shoulder will likely be the key to getting great results.
What exercises help shoulder impingement?
So we know exercise is research-proven to be just as effective as surgery for pain relief and improving function (Saltychev et al. 2014). Whilst one specific study looked at and demonstrated the effectiveness of eccentric exercises for the rotator cuff muscles and concentric/eccentric exercises for the shoulder blade stabilisers (Holmgren et al. 2012) there’s no research that says exactly which exercises are particularly effective.
This is where a good shoulder physiotherapist can be particularly useful in providing you with a program that’s tailored to your function, pain, and physical capacity to get the best outcome possible. Finding a great therapist makes rehabilitation relatively easy.
At Thrive Physio Plus part of your shoulder treatment involves exercising the shoulder using a variety of push, pull, raise, carry and lift movements depending on the exact nature of your shoulder symptoms. Starting with gentle exercises if you are in a lot of pain and progressing to more challenging exercises as your muscle strength improves and pain decreases is a great way to rid yourself of shoulder pain or shoulder injury for good.
The video below explores what a good shoulder physiotherapist prescribed rehab session should look like. It should be mentioned that in reality, each exercise is specifically tailored to the individual and their level of pain and function at the time. The following exercises are just an example of some of the strengthening exercises we commonly use when treating shoulder pain.
What exercises should you avoid with shoulder impingement?
Ultimately, none! Of course, often in the early stages of rehabilitation generally, we avoid more complex movements, but as the pain subsides and function improves we seek to expose the shoulder to a wide variety of movements of exercise in order to build a strong, robust and pain-free shoulder.
When completing a shoulder physiotherapist rehab program, contrary to popular belief, minor discomfort is actually ok when performing your exercises. So long as the pain is tolerable for you, and your symptoms return back to baseline within 24 hours, that level of exercise is ok.
So what that means is exercises that you may think you should avoid because they are painful, may not necessarily need to be avoided after all.
When should you go to a physiotherapist?
Ideally, the earlier the better. We know the longer your symptoms have been present, the longer and more difficult they can be to resolve completely. Pain also becomes more complex if you’ve had symptoms for more than 12 weeks which can sometimes extend recovery timeframes.
Ultimately, although earlier is better, if your shoulder injury is affecting your life and preventing you from doing the things you need and love, the best time to visit your local physio is now. Physiotherapy is a research-backed shoulder pain treatment, and a local shoulder physiotherapist can give you guidance for your specific scenario and kickstart your recovery.
If you have any questions or would like to chat with one of our friendly and professional team, please don’t hesitate to give us a call on 8490 0777 or email us at firstname.lastname@example.org.