Shoulder Pain

The shoulder joint is a very complex, highly mobile structure that actually comprises 3 different joints:

• The glenohumeral joint: where your upper arm (humerus) connects with your shoulder blade (scapula)

• The acromioclavicular joint: where your shoulder blade (scapula) connects with your collarbone (clavicle)

• The sternoclavicular joint: where the collarbone (clavicle) meets the chest bone (sternum)

• The 4th joint scapulothoracic joint: is not really a joint between 2 bones, but the shoulder blade glides over the thoracic spine. It is seperated with muscles and ligaments; no ligaments connect the bones at this ‘joint’.

​ There are many different muscles attaching to the shoulder joint and as it’s the most mobile joint of the body, many things can go wrong with this part of the body. The ‘outer sleeve’ muscles are the pectoralis muscles, the latissimus dorsi, the deltoid muscle and the trapezius. Underneath, we can find the ‘core muscles’ of the shoulder: levator scap, rhomboids, serratus anterior, pec minor and the subclavius muscle. ​ Important muscles to stabilise the upper arm into the shoulder blade are called rotator cuff.

CAUSES OF SHOULDER PAIN

• Arthritis

• Inflammation (tendons, the shoulder capsule, bursa)

• Injuries

• Instability (structural and mechanical)

• Referred pain into the shoulder (from the neck)

• Reduced mobility in the mid back (please see the page about back pain to learn more about this)

  
  

Scapular dyskinesis:

Shoulder pain may arise from a dysfunction in movement that may not be necessarily related to weakness or tightness of the muscles of the shoulder but rather coordination (motor control). The scapula must move in a manner that allows the shoulder joint to change position as the arm is brought over head and to the side, if the scapula fails to move appropriately this can also cause pain in and around the shoulder joint due to compression or impingement of the shoulder joint. Our physios can assess scapula position at rest and during movement through functional testing to determine whether your shoulder pain is related to diminished control of the scapula during movements of the upper limb.

"Physiotherapy should be one of the first treatment approaches for shoulder problems."

SHOULDER PAIN TREATMENT PHYSIO K

A good understanding of the shoulder joint is needed. Everything in the body is connected through fascia and sometimes a tightness in one area can cause problems in another area. This happens a lot with the shoulder. The rib cage or the low back could be the culprit and shoulder pain can be the result. At Physio K, we have a deep understanding of how the body functions and how other areas can be the cause of your problems. Soft tissue work, dry needling, joint mobilisations and manipulation, traction, education and exercise therapy are all treatment methods which can be used to effectively alleviate the shoulder pain. ​

In the video bellow, Kenny from Physio K runs you through an exercise program to increase the mobility of your shoulders.

Shoulder mobility exercises ​

1. Arm swings

This one is great in the initial stages of shoulder rehab or after shoulder surgery. Standing up and bending forward with the other (non-affected) hand and arm on a table below you. Make sure you put your body weight on that other arm, so you don't have any pressure

in your lower back.

From here we'll start swinging, try to swing your arm up and down. Imagine having a small weight in your hand, you could even have a little weight in your hand and let it swing like a pendulum up and down. Small movements are fine, try not to control the movement, just let your arm swing. Do that for about a minute.

The next one is swinging left and right for a minute and then making circles and swinging clockwise and anti-clockwise. Try to do those one minute each so that's about four minutes in total.

2. Crawling up the wall

Start with facing a wall and touch the wall with your toes and your nose. Now put one hand up against the wall about shoulder height and start crawling up with your fingers. Try to crawl as high as you can, hold for a few seconds before sliding down until the beginning position. Repeat this for about 15 times.

3. Stick exercises

With a broomstick in your hands, shoulder width apart, moving up and down behind your head. Try to extend your elbows all the way and come back down behind the head.

Then, try to make circles in the air, forward and backwards. Do this for about 10 to 15 times each.

Lastly, the most challenging one is called shoulder dislocations (don’t try this if you have dislocated your shoulder in the past). Hold the stick as wide as you can over your head and try to go backwards behind your head, keeping your elbows extended. Try to go until you touch your lower back, and then come back up. Repeat 10 to 15 times.

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​Shoulder stability exercises

In the above video, Anthony from Physio K runs you through a shoulder strengthening program, targeted specifically if you have any shoulder pain or weakness within your shoulder.

These are the 3 exercises we would recommend:

1 . Rotator cuff strengthening exercise: external rotation

To perform this one, you're going to start by holding a theraband in your hand, making a nice fist, pointing up at the roof and keeping your elbow nice and close to your side. You're going to gently rotate your arm outwards, stopping at about 30 to 45 degrees.

For this exercise we're looking to engage that rotator cuff, so we want to make sure that there's tension on the theraband the entire time and we're looking at repeating this for 10 reps and repeating that three times.

2. Rotator cuff strengthening exercise: internal rotation

This exercise is very similar; the only difference is we're doing it the opposite way. So we're going to have you holding it in that same hand with the same grip and you're just going to start by pulling from outside to inside, towards the belly button.

For both of these exercises, you can have the theraband anchored on a doorknob or something roughly about this height, belly button height.

3. Straight arm pull back

For this exercise, you're going to hold a theraband in a closed fist pointing down, making sure your elbow is nice and straight as you do that. Then you're going to extend your fist so it comes straight past the hip.

All of these exercises should be performed 10 times and repeated three times.