Shoulder Pain

Shoulder pain is the 3rd most commonly experienced musculoskeletal pain (exceeded only by low back and neck pain), with over 10% of the general adult population experiencing an episode of shoulder pain in their lifetime. 

Your shoulder is an extremely mobile joint! It is the joint with the greatest range of movement, more than any other joint in the body by a country mile. This increased mobility comes as a result of a small contact surface area between the humerus (upper arm) and the scapula (shoulder blade)...only 30%. 

The shoulder joint is a ball and socket joint. It has a big ball, and a very small socket – quite like a golf ball and tee, but pick it up out of the ground and tip it on it’s side. 

Got the picture? 

The result of this relationship is increased movement (especially when compared to the hip – another ball and socket joint), and poor stability. Many cases of shoulder pain are the result of dysfunction or weakness in the stabilising muscles of the shoulder, your rotator cuff. Shoulder pain physiotherapy will help to repair the cause and the effect of joint dysfunction.

We at PEAK are ‘1st point of call’ experts in the assessment and treatment of all types of shoulder pain – from desk related overuse to elite throwing athletes & swimmers.

Shoulder pain can develop slowly and manifest over a period of time, or, it can be the result of a traumatic injury, such as a fall onto an outstretched hand or via direct contact to the point of the shoulder (generally the shoulder will come into contact with the ground first in a rugby tackle, or via a ‘dumping’ in the surf). These ‘direct trauma’ injuries are often considerably painful, and are often accompanied by large degrees of movement limitation.

Gradual onset of shoulder pain is often described as:

• A deep, dull ache with pain radiating down the upper arm into the lateral deltoid or bicep
• A sharp pinching or blocked sensation
• Difficulty with lifting your hand above your head (hanging out the washing), or out to the side
• Difficulty and pain reaching behind your back to put shirts and jackets on, or for our female patients – when attempting to do up your bra
• Pain with lying on your sore shoulder at night.

Given that the shoulder joint is highly unstable, it is the task of your rotator cuff muscles to keep that ball (your humeral head) centred on the tee (your glenoid) whenever your deltoid is activated and you move your arm. 

If the function of these rotator cuff muscles is anything less than perfect, you will be placing other structures in your shoulder at a higher risk of pain, injury and inflammation.

Common Conditions Include:

• Sub-Acromial Impingement & Bursitis
• Rotator Cuff tendinopathy, or tearing (partial vs full thickness)
• Long head of Biceps tendinopathy & dysfunction
• Adhesive capsulitis OR ‘frozen shoulder’
• Multi-Directional Instability (MDI)
• SLAP lesion (Superior Labrum from anterior to posterior)
• Labral Tears
• Subluxations and dislocations – ligament & capsular damage = further shoulder instability
• Acromio-clavicular (AC) joint sprains
• Sternoclavicular joint sprains
• Head of humerus fractures or bony lesions
• Clavicle fractures
• Scapula fractures.

Given that we are all constantly using our arms to accurately position our hands throughout the day, be it simply using the keyboard and mouse at work, or lifting/moving heavy and bulky items, good shoulder function is critical to a happy and healthy life. 

We at PEAK take great pride in thoroughly assessing the cause of your shoulder pain – commencing with a detailed history of your current injury and all previous shoulder pains, establishing the mechanism (if any), identifying all aggravating and easing factors, trawling through the 24 hour pain patterns of this injury, and we follow this with a comprehensive physical examination.

With a shoulder pain physiotherapy session at PEAK you will receive:

• A more accurate diagnosis
• The best, and most up to date treatment applied appropriately
  • ‘Hands on’ & exercise based only, NO machines
• A tailored rehabilitation program – to better help you achieve your individual goals sooner, &
• Referral for further investigations (X-Ray/MRI), or specialist opinion as required.
  • We have been working as physiotherapists in Sydney CBD for greater than 10yrs now, and we have a very strong network, consisting of the very best people currently working in healthcare in Sydney.

Treatment of shoulder joint pain is an area of clinical expertise amongst all of the Physiotherapists at PEAK. Goals of treatment, specific to the shoulder are:

• Get pain & inflammation down
  • Rest, slings, ice, anti-inflammatories as needed.
  • Restore full range of motion
  • Enhance independent strength of all rotator cuff muscles, particularly subscapularis
  • Most importantly, improve stability of the shoulder joint
    • Encourage greater teamwork within the rotator cuff muscle group
    • We have a 5 stage stability system that we take all of our shoulder pain patients through
    • We believe we get great results when all of the above is applied!