Shoulder Pain
The shoulder has more movement than other joints in the body and so it can be prone to injury. There are also a lot of structures in a relatively small space between the collar bone and the top of the arm that can get aggravated easily causing pain in the shoulder, arm and neck. So for a small area it can cause big problems. When it is sore, things that you normally take for granted like putting on your coat or sleeping on it can be very sore, let alone trying play sport or do heavier activities like painting or manual work.
Pain and Weakness Around the Front of the Shoulder
Where are the symptoms and what does it feel like?
One of the most common types of pain in the shoulder is caused by the small tendons that insert into the top of the shoulder and give it stability - like the rotator cuff or biceps. Injuries to these tendons tend to give pain in the top or the front of the shoulder. The shoulder can feel sore and weak on lifting your arm up or out to the side or carrying things. It can also be sore to lie on.
How does it happen?
Our tendons can get a bit worn as we get older or they can get injured if you had a fall onto the shoulder. You can also get injuries with activities that you do over and over again – sometimes called overuse injuries – for example hard serving in tennis, overarm stroke in swimming, work that involves repetitive overarm activity like painting.
What is it stopping you from doing?
Rotator cuff injuries will stop you doing sports and any overhead activities – you will usually be ok if you use your arm at waist height but if you lift the arm past a certain point your shoulder will feel sore and weak.
How can we get you better?
Rotator cuff injuries respond well to progressive controlled strengthening so we’ll show you how to do that. We’ll also look at other factors that might have caused the tendons to get sore in the first place like posture, muscle imbalances or stiffness in your upper back.
Stiff and Sore Shoulder (“Frozen Shoulder”)
Where are the symptoms and what does it feel like?
A stiff, “frozen” shoulder can present itself in different ways but the real hallmark of it is that you start losing movement in your shoulder – you can’t reach up to that shelf or wash your hair or put on your coat. It tends to start slowly but then gets worse. It eventually gets better but it can take many months. It can be VERY sore and can keep you awake at night.
How does it happen?
All of the structures in the shoulder are enclosed in a capsule of tissue. This capsule thickens and stops your movement. It is not clear what actually causes frozen shoulder. Sometimes it just happens. Other times it might happen an injury or if your shoulder has been immobilised for a while.
What is it stopping you from doing?
Frozen shoulder can really cause problems with moving your arm and if this happens it stops you doing lots of things from easy day to day stuff like putting on clothes, doing jobs around the house to pretty much any kind of activity or sport that involves taking your arm away from your body.
How can we get you better?
There tends to be 3 phases to frozen shoulder and physio treatment is different for each phase. We can tell you which phase you are likely to be in and what we can do to help you get your movement back and ease the pain. Sometimes we will have to link in with your GP if the pain is bad and you need help with that to get more out of the rehab.
Sore Shoulder with Arm and Hand Symptoms (possibly nerve pain)
Where are the symptoms and what does it feel like?
When you have shoulder or arm pain and/or other symptoms, like pins and needles running down your arm or into your hand, you may have some nerve pain. Nerve pain can be very sore and can often feel like a toothache in your arm. Your shoulder and arm can also start feeling weak.
How does it happen?
Sometimes the discs and joints get some wear and tear in them as we age and this can irritate the nerve that comes out of the neck and into the shoulder and arm. Sometimes its plain old bad posture causing the nerves to get irritated. Other times it can be an injury, like a “stinger” in rugby when you get an impact around the neck/upper back.
What is it stopping you from doing?
Nerve pain can be very sharp and sore and can stop you in your tracks. Sleeping at night can be a problem. Doing activities and sports where your arm is stretched out to the side can be a problem. It can be sore even when you are not moving.
How can we get you better?
We’ll check out your neck, your upper back and your shoulder joints and we’ll do nerve tests to find out what is causing the pain. We’ll tell you if your posture needs to be changed and how to do it. You may need manual treatment on structures of the neck and shoulder to get things moving again and we’ll show you ways to stop it coming back. If your arm is weak we’ll help you to strengthen it.
Shoulder Arthritis
Where are the symptoms and what does it feel like?
Arthritic pain in the shoulder can cause pain deep inside the joint and when you move it might feel a bit grindy or clunky. The shoulder can feel stiff and your movement might be a bit limited. It can also cause pain at night when you lie on it.
How does it happen?
Arthritis or “wear and tear” happens as we get older. The cartilage that makes the joint move smoothly gets damaged and can cause pain. If there is a lot of wear and tear in the shoulder and it is very sore then you may need surgery. However shoulder replacements are much less common than say knee or hip replacements.
What is it stopping you from doing?
Arthritis in the shoulder can make your shoulder feel stiff and restrict your movement. It can also keep you awake at night. Usually when there is wear and tear in the joint, you may also get wear and tear in the ligaments and muscles so the whole lot together can give weakness and stiffness meaning that moving it and lying on it can cause pain.
How can we get you better?
We can get your shoulder moving again by loosening up the joint and getting the muscles and tendons stronger to support the shoulder. We can also advise you on things that might be making things worse like posture, stiffness in other areas like the neck and upper back or activities that may be aggravating the area.
Shoulder Fractures, Dislocations and Post Surgery Rehab
Where are the symptoms and what does it feel like?
Whether you have broken the bone in your shoulder, had a ligament or muscle surgically repaired or dislocated your shoulder you will usually be put into a sling for usually up to 6 weeks.
How does it happen?
Your arm/shoulder can break if you have a bad fall on it. You can dislocate your shoulder if you fall awkwardly on it. Sometimes people dislocate their shoulder if they are naturally “loose jointed”. Common surgical procedures for shoulders are rotator cuff repairs (to fix a tear in some of the important small muscles in the shoulder) or stabilisation procedure (where there is a tear in the covering of the shoulder joint that keeps everything together) or surgical fixation for fractures.
What is it stopping you from doing?
Once you are in a sling your shoulder and arm movement are limited to allow the tissues to heal and recover. Even when you come out of a sling your movements will still be limited for a while. Your shoulder may be stiff and weak so it times take to get your movement and confidence back to return to day to day activities or sport.
How can we get you better?
When you come out of a sling we will work with your surgeon’s guidelines to help you get your shoulder back to function by getting your movement back, treating the stiffness, getting your arm stronger and gradually getting you back to your activities and sports.