Shoulder injuries are one of the most common complaints that physiotherapists treat. The British Elbow and Shoulder Society (BESS) estimates than 14% of the adult population will experience an episode of shoulder pain each year. Sometimes this may be due to some trauma for example a fall or strain to the shoulder and other times it may be a repetitive overuse or postural problem (such as amongst desk workers).

Common Causes of Shoulder Pain

Frozen shoulder.  This is most common in people over 45 and tends to affect women more than men.  It is also more common in your non-dominant arm and if you are a diabetic.  It is characterised by progressive stiffness of the shoulder and an inability to lie on the affected side in bed.

Impingement syndrome is caused by pinching of the rotator cuff muscles in the shoulder.  The causes of this can be multi-factorial, for example weakness of the rotator cuff muscles, a slumped or rounded posture, osteoarthritis of the ACJ (a small joint on top of the shoulder).

Rotator cuff tear can occur in younger patients (aged 30-50) after trauma such as a fall onto the shoulder or as a degenerative tear in the more elderly population.  Some literature shows that by the age of 80 up to 80% of the population demonstrate tearing of the muscle on ultrasound.  A tear to the rotator cuff will cause extreme weakness in the shoulder as well as pain.

Osteoarthritis tends to affect the more elderly population.  Osteoarthritis is a normal part of the aging process and occurs when the articular cartilage of the shoulder wears away over time.  In conjunction to this your body often overproduces bone called osteophytes which can further impede movement.  The main complaints are therefore of pain and stiffness.

Dislocation and instability. Dislocations typically involve high velocity trauma and the ball coming out the front of the socket however, a small percentage of the population with hypermobility can find that their shoulder dislocates regularly on events such as getting dressed or running down the stairs.  This requires intensive physiotherapy and rehabilitation to correct.

Other common causes include SLAP lesions, acromioclavicular joint problems and fractures of the shoulder

How can physiotherapy help with your shoulder pain?

Initially we will take a comprehensive subjective history by asking you lots of specific questions about your shoulder pain.  This is necessary because as you see from above, different shoulder problems have different presentations.  We will then complete a thorough examination of your shoulder to pin point the problem, explaining this too you as we go.

Treatment will depend completely on the problems identified but may include anything from joint mobilisations and manual therapy, soft tissue release, strengthening and stabilising exercises, taping or acupuncture.  A small percentage of shoulder problems may require further investigation such as an ultrasound scan or an X-ray.  We will liaise with your GP if this is the case to make sure that your pathway is as smooth and efficient as possible.

If you would like to discuss whether physiotherapy would benefit your shoulder problem, or to book an appointment with one of our expert Chartered Physiotherapists, please give our team a call on 01202 725090.

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