The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed and this instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.
Shoulder pain may be localised or may be referred to areas around the shoulder or down the arm. The shoulder and the neck have a close relationship and chronic dysfunction in one can lead to problems in the other. Pain felt in the region of the shoulder blade or scapula nearly always has its origin in the neck.
Sport & Spinal Physiotherapy has helped many clients from Gungahlin and the wider Canberra community with all types of shoulder pain syndromes.
Shoulder Instability refers to either dislocation or subluxation (partial dislocation). The shoulder joint is the most frequently dislocated major joint of the body. In a typical case of a dislocated shoulder, a strong force that pulls the shoulder outward (abduction) or extreme rotation of the joint pops the ball of the humerus out of the shoulder socket. Dislocation commonly occurs when there is a backward pull on the arm that either catches the muscles unprepared to resist or overwhelms the muscles. After the shoulder has been relocated, physiotherapy can help restore some stability by strengthening the muscles around the shoulder. Surgery may be required for recurrent episodes of instability.
AC Joint Separation occurs when the ligaments that hold the collarbone (clavicle) to the shoulder blade at the acromioclavicular (AC) joint are torn. Typically, this occurs when there is a blow to the shoulder or a fall on the outstretched hand.
Shoulder Impingement Syndrome (Bursitis) occurs when the rotator cuff tendons or bursa are inflamed due to being pinched between the top of the humeral head and the acromion of the shoulder blade. In nearly all circumstances poor muscle control around the shoulder joint and shoulder blade are to blame. Pain is experienced at the shoulder or upper third of the arm and aggravated by lifting away from the body or overhead activities. This is the most common type of shoulder pain and is usually resolved with effective physiotherapy.
Rotator cuff tears can occur suddenly from a fall on the outstretched hand or slowly from degeneration. The rotator cuff tendons act together to provide stability and motion, however if a large tear occurs in one or more tendons, then shoulder dysfunction can occur including difficulty lifting the arm. The supraspinatus tendon is the most commonly torn cuff tendon. Most cuff tears can usually be treated well conservatively with physiotherapy. However, if the tear is substantial then surgery may be required to repair the tear and restore shoulder function.
Labral Tears occur when the cartilaginous ring (labrum) around the shoulder socket tears or delaminates from the socket. Some tears may also extend into the biceps tendon. Labral tears can cause instability of the shoulder, typically in overhead movements. Symptoms include a dull ache deep in the shoulder joint, trouble sleeping due to the instability and discomfort, and extreme weakness in overhead activities.
Frozen shoulder, otherwise known as adhesive capsulitis, involves severe restriction in the shoulder joint. The condition is frequently caused by injury that leads to a lack of use due to pain, resulting in joint stiffness and the formation of adhesions in the joint. The condition rarely forms in people under the age of 40 years. Physiotherapy is usually successful but the process can be lengthy.
Fractures of the shoulder can occur after a major injury and is usually accompanied by severe pain. If the fracture is relatively undisplaced, then conservative management with physiotherapy alone can help achieve a full recovery.
Other sources of shoulder pain are arthritis of the shoulder joint, arthritis of the AC joint (osteolysis), biceps tendinopathy and sternoclavicular joint separation.
How can Sport & Spinal Physiotherapy help your shoulder injury?
In most cases, physiotherapy alone offers an effective solution for most shoulder injuries. During your first visit, our physiotherapists will examine your shoulder to determine what structures have been damaged. In chronic pain cases without trauma we will also assess your neck as your pain may be referred. Establishing the correct diagnosis early is imperative as several injuries mimic symptoms yet have different treatment protocols. We use our unique ‘phase based rehab system’ to ensure all aspects of a full and lasting recovery are delivered. We will tailor a treatment plan to suit your needs, with you involved in the decision making so that we address your biggest concerns. Early treatment will be focused on reducing pain and swelling and regaining range of motion. Our physios will use hands on therapy techniques to improve joint mobility and muscle flexibility. We will nearly always at each session provide home exercises of stretches and strength work so that you keep improving between sessions. The physiotherapist will then prescribe an exercise program to improve the strength and coordination of your shoulder, which are important for preventing re-injury. Massage, hydrotherapy, dry needling and our gym may also be used for best outcome. Towards the end of your program you will be given strategies to keep the pain away. The sooner we begin your shoulder rehabilitation, the faster your recovery and back to the things you love doing.
Why choose us for your shoulder pain?
- We listen, we care and we get results
- We provide physiotherapy to fix the cause of your shoulder injury and not just the symptoms
- We have extensive experience in dealing with all types of shoulder pain
- We have physios who have special training in shoulder injuries having completed further studies
- We can refer you for further investigations such as x-ray or MRI if required
- Our therapists are passionate about sport and engage in an active lifestyle
- We understand the demands and technique involved in all sport types
- We can provide dry needling for pain management and accelerated healing
- We can use our gym for advanced upper limb strengthening
- We can supply practitioner only natural anti-inflammatory supplements to help healing
- Our massage therapists can help improve muscle flexibility around the shoulder
- Our hydrotherapy sessions can be very effective for early rehabilitation of shoulder injuries particularly post-surgical
- Our therapists have been recognised for their expertise having been national sporting team consultants
- Many of our physios work with local, state, national and international teams and athletes
- We give you cross training activities so you can maintain your fitness whilst injured
- We provide you with the tools to look after your health long after you leave our care
- We provide you with a guided return to sport with any technique modifications or training restrictions
- We can recommend referral to a medical specialist if need be to see if your shoulder injury requires surgery
- We can work with your surgeon after any shoulder surgery to obtain a successful result