Shoulder pain can cause persistent discomfort and interfere with simple daily activities, from getting a restful sleep to reaching to the backseat of the car. There are multiple possible causes of shoulder pain, meaning it is important that an individual assessment is made to provide the correct symptom relief.
Whether you have received an injury diagnosis or not, Exercise Physiology can be helpful for shoulder rehabilitation.
How the shoulder works
The shoulder, with its high capacity for movement, is one of the most complex joints in the body. It involves the joint, as well as muscles and tendons that surround it. It has several key parts:
- Three large bones which meet at the shoulder:
- The shoulder blade (Scapula)
- The collarbone (Clavicle)
- And the humerus
- Three main joints:
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- The glenohumeral joint
- The acromioclavicular joint
- The sternoclavicular joint
These joints are responsible for the high capacity of movement in the shoulder.
- There are also many muscles that form parts of the shoulder, such as:
- The deltoid
- The trapezius
- The rhomboid major and rhomboid minor
- An important group of muscles are the rotator cuff muscles – this includes the Supraspinatus, Infraspinatus, Teres minor, and Subscapularis muscles. Injuries to these muscles are called rotator cuff injuries, and cause many instances of shoulder pain.
- A fluid filled sac in the joint called the bursa. This can sometimes become inflamed and painful.
Types of shoulder pain:
Because the shoulder has a number of complex structures and anatomy, there are many potential causes for shoulder pain.
Arthritis
Being aged 50 or more, or shoulder injuries such as dislocation, can increase the risk of developing shoulder osteoarthritis. This is a degenerative condition affecting the cartilage in the shoulder. This often causes pain, difficulty sleeping or lifting items, and can limit shoulder mobility. Other types of arthritis such as rheumatoid arthritis may also cause pain in the shoulder.
Tears
A tear occurs when the tendon, which connects the muscle to the bone, becomes partially or fully disconnected to the bone. Risk factors for tears can be age related or due to excessive wear from repetitive motions. In more severe cases, this may require surgery. Tears affecting the rotator cuff muscles are called rotator cuff tears. An Exercise Physiologist can provide rehabilitation for rotator cuff tears with or without surgery.
Tendinitis
Tendinitis occurs when there is inflammation of the tendons in the rotator cuff, or the biceps tendon. This can be caused by a tendon becoming impacted on by other parts of your shoulder (often when mobility in certain movements is lacking), or through injury.
Bursitis
Bursitis occurs when the fluid filled sac cushioning the tendons and the bone in the shoulder joint becomes inflamed. This tends to cause significant pain when the shoulder is moved in a certain manner.
Other conditions that can cause shoulder pain include:
- Pinched nerve
- Referred pain
- Frozen shoulder
- Bone spurs
- Dislocated shoulder
- Injury due to overuse or repetitive tissue trauma
In many cases shoulder pain is idiopathic. This means that it begins randomly and might not be triggered by any event in particular. This type of shoulder pain means we need to examine the symptoms with a more broad view of the body. An Exercise Physiologist is likely to investigate whether the shoulder pain is a symptom of immobility elsewhere, such as through the shoulder blades and mid-back. This is why it’s important to see a health professional such as an Exercise Physiologist – as a team we have knowledge and experience of the complexities of the human body and know how each joint relates to the next.
What does shoulder pain feel like?
Depending on the cause and location of the problem, shoulder pain will feel different, due to varying symptoms. Here are some of the common symptoms that somebody experiencing shoulder pain may feel:
- Deep pain in the shoulder joint
- Pain at the front or back of the shoulder or at the top/outside of the arm
- The quality of the pain may feel sharp, sudden, or it may be a constant ache
- Reduced mobility and ability to use the shoulder and arm in daily activities
- A sense of weakness in your affected arm, including affected grip strength
- ‘Carrying’ the shoulder, which can lead to further loss of mobility and weakness.
Exercise Physiology for shoulder pain
We will ask questions about your medical history and symptoms, as well as conducting a physical assessment. We will work with you to help identify your shoulder pain, and then we will implement a plan to help ease symptoms, involving self-massage exercises, mobility and postural exercises, and strength-building exercises. We will do our utmost to guide you to achieve improved outcomes, reduce shoulder pain and improve quality of life.
“After having frozen shoulder, I assumed I would never have full mobility in my left shoulder. The reduced mobility, and the pain I was experiencing, was impacting on my ability to enjoy a more active life.
I was recommended by an associate to see Ben at Restart Exercise Physiology. Ben was amazing, he understood the issue with my shoulder and what my goals for recovery were. Ben then established a clear plan of exercises I could do, to start improving mobility and increasing strength in my shoulder.
Within 3 weeks of starting the exercises, I could already feel a positive difference in my shoulder. When seeing Ben again, he listened to my feedback and made adjustments and we continued to see improvements.
After having frozen shoulder, I never thought I would have a pain free shoulder with normal mobility, so I am always so thankful to Ben.”
Anita, 45
Shoulder Pain treatment at Restart Exercise Physiology
As Exercise Physiologists we understand the intricacies of the shoulder, as well as the complex range of requirements for rehabilitation and pain management. We will carefully analyse your movement and discuss your diagnosis and symptoms in order to develop the best range of exercises. This will decrease your symptoms whilst increasing mobility and strength.
If however we are not the right fit for you and the complexity of your injury and pain, we are capable of advising you as to the best course of action and the best professional to seek further advise from.
We understand that shoulder pain can be debilitating. Book an appointment with Restart to help break the injury cycle and get back to doing what you love, pain free!