Understanding Shoulder Pain

The shoulder is a highly mobile joint that allows for a wide range of motion, making it prone to injury and pain. Shoulder pain can arise from issues with the muscles, tendons, ligaments, or bones that support and move the shoulder joint. Pain in the shoulder can affect daily activities, such as lifting objects, reaching overhead, or even sleeping, and can vary from mild discomfort to severe, debilitating pain.

At Active Pulse Physiotherapy, we specialize in diagnosing and treating shoulder pain using a holistic approach that targets the root cause of the pain and provides long-lasting relief.

Common Causes of Shoulder Pain

1. Rotator Cuff Tendinitis
   • What is it? The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint. Overuse, repetitive motions, or strain can cause inflammation of these tendons, leading to pain and limited mobility.
   • Symptoms: Pain when reaching overhead or behind the back, weakness in the shoulder, and difficulty lifting objects.
2. Rotator Cuff Tear
   • What is it? A rotator cuff tear occurs when one or more of the tendons in the rotator cuff are torn, either partially or completely. This can happen due to overuse or an acute injury.
   • Symptoms: Sharp pain, weakness, difficulty lifting the arm, and limited range of motion.
3. Shoulder Impingement Syndrome
   • What is it? Impingement occurs when the tendons of the rotator cuff become compressed between the bones in the shoulder, leading to inflammation and pain.
   • Symptoms: Pain when lifting the arm, reaching overhead, or lying on the affected shoulder.
4. Frozen Shoulder (Adhesive Capsulitis)
   • What is it? Frozen shoulder is a condition that causes stiffness and pain in the shoulder joint due to inflammation and thickening of the joint capsule. It usually develops gradually and can last for months to years.
   • Symptoms: Progressive stiffness, reduced range of motion, and persistent pain, especially at night.
5. Bursitis
   • What is it? Shoulder bursitis is the inflammation of the bursa (small fluid-filled sacs) in the shoulder, which cushion the tendons and bones. This condition can result from overuse, injury, or repetitive motions.
   • Symptoms: Pain and tenderness in the shoulder, especially with overhead movements or pressure on the shoulder.
6. Shoulder Arthritis
   • What is it? Arthritis in the shoulder occurs when the cartilage in the joint wears down over time, causing pain, stiffness, and reduced range of motion. Osteoarthritis is the most common type affecting the shoulder.
   • Symptoms: Dull, aching pain, stiffness, and difficulty with shoulder movement.
7. Shoulder Dislocation or Instability
   • What is it? Shoulder dislocations occur when the upper arm bone (humerus) comes out of the shoulder socket. This can cause instability in the joint, leading to recurrent dislocations or subluxations (partial dislocations).
   • Symptoms: Severe pain, a visibly deformed shoulder, and an inability to move the arm. Instability may cause a feeling of the shoulder “slipping” out of place.
8. Tendinitis
   • What is it? Inflammation or irritation of the tendons in the shoulder, often due to repetitive activities or overuse.
   • Symptoms: Pain with movement, stiffness, and tenderness along the tendon.
9. Labral Tears
   • What is it? The labrum is a ring of cartilage that surrounds the shoulder socket. A tear in the labrum can result from acute injury, repetitive shoulder motions, or dislocation.
   • Symptoms: Pain, clicking, or locking in the shoulder, especially during overhead activities.

Symptoms of Shoulder Pain

• Pain: Either localized in the shoulder or radiating down the arm, which can vary from sharp to dull.
• Stiffness: Difficulty moving the shoulder, particularly when reaching overhead or behind the back.
• Weakness: Feeling of instability or weakness in the shoulder, making it hard to lift or carry objects.
• Swelling or tenderness: Inflammation in and around the shoulder joint.
• Limited range of motion: Difficulty moving the shoulder through its full range of motion.
• Clicking or popping sounds: Often associated with labral tears or rotator cuff issues.

How Active Pulse Physiotherapy Can Help with Shoulder Pain

At Active Pulse Physiotherapy, we offer evidence-based, individualized treatment plans to address the root causes of your shoulder pain. Our goal is to relieve pain, restore mobility, and improve function, allowing you to return to your normal activities without discomfort.

1. Comprehensive Assessment and Diagnosis

Our first step in treating shoulder pain is a detailed assessment to identify the specific cause of your pain. This includes:

• Medical history review: Discussing your symptoms, previous injuries, and activities that may have contributed to the condition.
• Physical examination: Assessing your shoulder’s range of motion, strength, and areas of pain or tenderness.
• Specialized tests: Performing functional tests to identify the underlying issue, such as impingement, rotator cuff tears, or instability.

If needed, we may refer you for imaging tests, such as X-rays, ultrasounds, or MRIs, to get a clearer picture of the problem.

2. Manual Therapy

Manual therapy plays a key role in relieving pain and improving shoulder mobility. Our physiotherapists use hands-on techniques, including:

• Joint mobilization: To improve the movement of the shoulder joint and restore normal function.
• Soft tissue mobilization: Including massage, myofascial release, and trigger point therapy to reduce muscle tension and improve circulation.
• Stretching and mobilization: To release tight muscles and tendons, improving flexibility and reducing stiffness.

3. Strengthening and Range of Motion Exercises

A personalized exercise program is essential for rebuilding strength, improving flexibility, and restoring function in the shoulder. Our physiotherapists will guide you through exercises that are tailored to your specific condition, including:

• Strengthening exercises: Targeting the rotator cuff muscles and other supporting muscles to improve shoulder stability and function.
• Range of motion exercises: Gradual exercises to restore full mobility in the shoulder joint without aggravating the pain.
• Posture correction: Exercises to correct poor posture, which often contributes to shoulder pain, especially in people who sit for long periods or engage in repetitive motions.

4. Pain Relief Modalities

To help manage pain and inflammation, we may use various modalities such as:

• Ice or heat therapy: Applying cold or heat to the shoulder to reduce swelling and alleviate pain.
• Electrical stimulation (TENS): Using mild electrical currents to block pain signals and promote muscle relaxation.
• Ultrasound therapy: Using sound waves to promote tissue healing and reduce pain in deep tissues.

5. Posture and Ergonomic Training

Poor posture and improper movement mechanics often contribute to shoulder pain. Our physiotherapists provide:

• Postural correction: Techniques to improve your posture during daily activities, work, or sports to reduce strain on the shoulder.
• Ergonomic advice: Guidance on optimizing your workspace or activity setup to minimize stress on the shoulder joint.

6. Education and Self-Management

We believe in empowering our patients to take control of their recovery. Our physiotherapists will provide:

• Home exercise programs: Specific exercises you can continue at home to maintain progress between sessions.
• Pain management techniques: Guidance on how to manage your symptoms with stretches, ice/heat application, and activity modification.

7. Injury Prevention and Long-Term Maintenance

Once your pain is under control, we focus on preventing future shoulder issues through:

• Strength and flexibility maintenance: Continuing a tailored exercise program to ensure that the shoulder remains strong and mobile.
• Education on body mechanics: Teaching proper techniques for lifting, carrying, and other activities to avoid re-injury.
• Sports-specific rehabilitation: For athletes, we offer sport-specific rehab programs that help you return to your activities safely and effectively.