Shoulder Pain

Shoulder Pain

Shoulder pain affects 15-20% of adults in Europe, with increasing likelihood in those of advancing age. Shoulder pain typically is associated with high levels of chronicity (longer than 12 weeks) and disability (unable to fully carry out normal daily activities). People who suffer with shoulder pain will often be diagnosed with a “Rotator Cuff” injury, tendinopathy, tear or impingement. This diagnosis will usually be confirmed with further investigations such as magnetic resonance imaging (MRI). Overall the initial diagnosis however will describe the condition of pain and weakness associated with shoulder movements.

What is the rotator cuff?
The rotator cuff is a group of four tendons that stabilize the shoulder joint. Each of these tendons attaches to a muscle that moves the shoulder in a specific direction. The four muscles involved are Subscapularis, Supraspinatus, Infraspinatus, and Teres minor muscles.

How can I injure my rotator cuff?
The Rotator cuff typically can be injured in two ways;
Through substantial injury to the shoulder from either a fall on an outstretched arm or accident.
OR
Progressive degeneration or wear and tear of the tendon tissue through repetitive tasks such as overhead activity, heavy lifting over a prolonged period of time. The development of bone spurs in the bones around the shoulder can then irritate or damage the tendon.

What are the symptoms?
The pain associated with a rotator cuff injury may:
Be described as a dull ache deep in the shoulder
Disturbed sleep, particularly if you lie on the affected shoulder
Difficult to comb your hair or reach behind your back
Be accompanied by arm weakness
How can my shoulder pain be treated?
Three major management strategies are available for the treatment of rotator cuff tendinopathy’s are as follows :

1. Physiotherapy and Exercise
Good level of effectiveness with low cost, but not optimal results in all populations or clinical settings.
2. Steroid Injections
Slightly better pain relief at 6 weeks compared to Physiotherapy and Exercise, but no difference after 12 weeks. Potential side effects.
3. Surgery
Equivalent results to exercise at 2 and 5 years, but double the cost, along with added risks.

Conclusions
Therapeutic exercise (physiotherapy and exercise treatment) has a positive effect on pain and function over and above all other interventions (steroid injections and injections), but limited evidence to suggest which parameters of exercise are important.

Structured exercise treatment should be the basis for treatment of shoulder impingement syndrome, with operative treatment offered judiciously until its true merit is proven.

But which Exercises should I Do?
To be sure which exercises are a suitable treatment option for your shoulder pain a full and thorough assessment by a chartered physiotherapist is essential.

To see some examples of a shoulder rehab program please click here.

For further advice and information on shoulder pain please see www.shouldercommunity.com

Alternatively contact us on 086 8049526

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