Shoulder problems are very common due to their design as a ball and socket joint. In order to move our arms to feed ourselves, throw, lift, pull, catch, climb etcetera, humans have evolved to develop mobility and flexibility at the shoulder joint at the expense of stability. The shoulder joint relies on muscles, ligaments and tendons to drive movement and provide relative stability. When the timing of the shoulder movement or muscle control is out of sync, pain and stiffness can result especially if movements are repetitive.
The shoulder is actually several joints that work in tandem through attachments of muscles, tendons and ligaments to provide the wide range of movement we require to survive. A normal shoulder allows the hand to reach the mouth for feeding, oral hygiene and lipstick! Brushing hair, dressing, throwing and many forms of employment are significantly affected when the shoulder becomes stiff and painful.
The shoulder complex is made up of the humerus, scapula and clavicle bones connected together through ligaments and muscles, commonly referred to as the rotator cuff. The shoulder relies heavily on the interaction between its components and occasionally things go wrong. Commonly we assess muscle injuries and tears also referred to as rotator cuff injury, repetitive injuries to tendons called tendinopathies and inflamed bursaes or bursitis. Shoulder instability can occur when the interaction between the joints and rotator cuff fall out of sync. Likewise impingement of muscles between the bones can occur through weakness, stiffness or muscle timing problems. Stiffness occurs when the soft tissue capsule surrounding the shoulder joint shrinks through conditions called frozen or constricted shoulder. Broken humerus, clavicle and less commonly scapular bones as well as arthritis are all causes of stiff and painful shoulders. Lack of use through pain and / or weakness may also develop shoulder stiffness.
If you have fallen and have shoulder pain it might be broken! If you have developed a painful shoulder over time it may well be due to repetitive use / mechanical irritation through work or hobbies (production line work, decorating, cleaning, bowling in cricket, sailing, badminton etc). Osteoarthritis becomes more noticeable as we age, is very common, also referred to as ‘wear and tear’ and may be related to work or sporting hobbies. If you have been diagnosed with diabetes or a thyroid condition you are susceptible to developing a frozen shoulder.
Self-help for stiff and painful shoulders
Self-help strategies of utilising pain medication such as regular paracetamol and ibuprofen not exceeding the doses recommended on the packets. Seeking GP advice for alternative medication if you are unable to tolerate these. Reducing where possible the amount of activity that increases your symptoms – not always easy. Changing your sleeping position if you experience pain overnight. Applying a hot water bottle / hot wheat bag over the shoulder whilst taking precautions to prevent burns may be beneficial. Ice packs similarly with precautions can help alleviate symptoms to more manageable levels.
Fay Pedler Physiotherapy
As physiotherapists we are expertly placed to assess all shoulder conditions and you would be wise to consider an appointment if you are experiencing problems. You can easily book online here or call our excellent reception team on 664519.
An appointment with one of the team will involve a thorough history taking of the problem including any duration of symptoms, past problems, what difficulties you are experiencing, whether symptoms are due to trauma or overuse, any other conditions within your overall health and what your desired outcome of assessment is. A physical examination will assess your shoulder movement, strength and identify any swelling, deformity or restriction in order to successfully diagnose the problem and develop a treatment plan.
The Physiotherapists here at the clinic will utilise their vast clinical experience and skills to treat the stiff and painful shoulder thorough education of the condition, specific exercise for the diagnosed complaint, rest / modification from aggravating movements, joint mobilisations, soft tissue release, acupuncture and shockwave therapy as required. A rehabilitation programme will be developed in order to meet the goals agreed in the initial assessment.