​Predisposing factors

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If you have had any of these on the list below then it is more likely that at some stage you will develop shoulder pain.

 

These include:

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• Repetitive overhead activities

• Contact sports involving the shoulder

• History of repetitive injury or traumatic injury

• Occupation especially those with repetitive movements i.e. cashiers, assembly line workers, hairdressers, tradesmen and any other occupation where there is lots of lifting and/or repetitive movement

• Heavy lifting with little rest

• Stress

• Any of the above coupled with poor job satisfaction

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Common Shoulder Complaints

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Most shoulder pain that presents to clinic are musculoskeletal in nature and can be treated. The most common conditions of the shoulder in clinical practice are:

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• Rotator cuff tendinopathy/tear

• Subacromial impingement syndrome

• Frozen shoulder

• Osteoarthritis

• Shoulder instability

• Cervical disc

• Thoracic outlet syndrome

• Labrum tear

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These conditions in clinical setting are usually able to be treated without the prospect of surgery although that depends on their cause, chronicity, and also on the damage that is present in the tissue, as well as other bio-mechanical adaptations and compensations, and whether it is from micro-trauma or macro-trauma.

It is best if you do have any pain to get it sorted as soon as possible, the longer it is left alone, the further along the degenerative cascade it will be, making the injury harder to treat, longer to treat, more painful and a greater propensity for re-occurrence and the cycle continues without proper treatment.

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Prevention

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There are ways in which you can help yourself prevent a lifetime of pain or even reduce the pain that you have been receiving from your shoulder.

 

Some of these include:

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• Keeping a good upright posture with shoulders back and your head balanced nicely on top

• Before any physical exercise make sure that you have warmed up properly by doing a variety of exercises and stretches

• When exercising make sure that you are using proper technique, weights aren’t too heavy and that you are giving yourself enough time to rest, recover and recuperate

• Make sure that the bags that you are using are not too heavy, and where possible rotate the arms on which you rest your bag

• If you do feel pain make sure that you don’t leave it and make sure you get it corrected otherwise it is harder to treat, will take longer and there is less chance for success.

• Keeping regular appointments so that if there are any problems or the beginning of something, there is a good possibility that you are unaware of that until the very last moment when you begin to feel pain, so it is best to take control of something early or before it even begins to cause pain so that we are in control and dictating the terms as opposed to the pain dictating the terms.

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What we do for shoulder pain?

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If after our consultation we deem that the pain is from a musculoskeletal cause, and not from an organ, and we also deem it is within our scope of practice, a generalised treatment schedule goes accordingly:

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• Mainly practitioner provided treatment to help the injured tissues heal including soft tissue work, stretches, mobilisation, joint adjustment and other therapeutic modalities to aid in the correct restructuring of scar tissue.

• Progresses to the above plus various rehab protocols as well including correction of muscle firing patterns, strength and flexibility, joint proprioception work among others. This is the beginning of integrating the shoulder with the whole body. Progression through rehabilitation exercises depends on a number of things including actually committing to the treatment program, age, rate of tissue healing, tolerance, level of joint and muscle injury, pain, and a host of others.

• The last progression is where the whole body is corrected, including poor overall biomechanics, this stage depends on many factors, most of which you control, including positions that you adopt whether that is at work, home or at leisure time. This stage of treatment is crucial, if the poor movement patterns are not corrected properly it sets up the body for more pain in a later stage of life, ultimately leading to more pain.

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