JUST BECAUSE IT’S COMPLEX IT DOESN’T HAVE TO BE COMPLICATED.
PosturalIt would be untrue to say that posture is the number one factor leading to shoulder pain. Research has shown that static shoulder posture is actually poorly correlated with pain. With this is mind research does however suggest that staying in prolonged postures (for example – sitting at a desk all day) can lead to pain and stiffness in the shoulder and upper back. We have also seen this to be the case clinically. Especially in those less active. Typically, it is the muscles which begin to hurt but this muscular pain may lead to restrictions in joint movement and can occasionally irritate the nerves passing through the shoulder and chest which supply the arm. This may cause pain and pins and needles in the arm or hand. At Hardiman Performance our team our experts in the assessment of posture and how it may/may not correlate/contribute with your pain. We always aim to assess all likely causes getting to the primary issue to provide you with focussed treatment to decrease your symptoms initially and an action plan to get back to full function.
Rotator Cuff RELATED PAINThe shoulder is a shallow ball and socket joint to allow for large ranges of motion which gets its stability from the muscles which surround the joint, The rotator cuff muscles and the small muscles in your shoulder which are responsible for orientating the position of your arm in the shoulder socket and work aid stability to the shoulder. As the muscles of the shoulder are so important to its’ function the rotator cuff and other surrounding muscles are an important focus for the rehab of all shoulder issues. These muscles (rotator cuff) are highly active at all times of the day and can be prone to pain. Often it is the case that these muscles may become poorly adapted to the demands placed on them during the day and as a result dysfunctional Rotator cuff related shoulder pain is extremely common and can affect us all, office worker to athlete. Despite the majority of the muscle being at the back of the shoulder, rotator cuff pain will commonly be felt at the front or side of your shoulder. As the shoulder joint relies so much on the rotator cuff for its integrity, dysfunction can lead to weakness, poor range of motion and often night pain. For this reason, rotator cuff related shoulder pain is often confused with frozen shoulder (see below) as some of the symptoms are common in both presentations. After decreasing symptoms, the focus when working with someone with rotator cuff related pain is to build resilience in the shoulder so it is better able to cope with the demands placed on it through life and sport. Please contact if you would like to understand more about how we can help you with rotator cuff related shoulder pain.
Frozen ShoulderAdhesive Capsulitis commonly known as Frozen Shoulder is a condition which leads to severe shoulder restrictions, pain and a significant impact on quality of life. The underlying cause of the condition is not fully understood but it can affect people who already have some ongoing heath issues (diabetes, hypothyroidism etc) but also may develop from a separate shoulder issue. Unfortunately, with frozen shoulder, symptoms may persist for anywhere between 18 months and 3 years and during that time the focus should be to maintain as much function as possible, prevent further stiffening and manage pain. Along with conservative management (physical therapy, osteopathy, exercise) there are a range of other management strategies that can be utilised. These may include injection therapy, manipulation under anaesthetic, hydrodistension amongst others. Unfortunately, these more invasive approaches lack little evidence over conservative management and in some cases have been shown to cause harm. Every intervention should be discussed with you, the rehab team and consultant to ensure the management is correct for what you need at the current time. As always, approach will vary between individuals. The good news is that lots of more common shoulder issues which are shorter lived, less of a management challenge and respond better to conservative approaches are often misdiagnosed as frozen shoulder. If you are suffering with shoulder pain which has been diagnosed as frozen shoulder it is always worth getting a second opinion from a musculoskeletal specialist. As per the NICE guidelines, we advise that all those diagnosed with frozen shoulder receive an X-ray of the shoulder to rule out any non-musculoskeletal causes of joint stiffening.
In cases of traumatic dislocation, it is advised to visit the hospital to have the shoulder relocated under x -ray. This helps to avoid any complication with nerve impingement and can rule out any fracture caused during the trauma.
It is common for patients to experience significant pain in the shoulder region post dislocation due to the strains placed on the tissues during the trauma.
For active individuals it is also common for recurrent dislocations to occur and for that reason it is advised that a period of rehab is followed post shoulder dislocation. Our osteopaths will be able to guide you through and provide you with tailored rehabilitation programmes aimed at getting the shoulder back to full function, decreasing any pain and strengthening the musculature in order to prevent future dislocation.
Thoracic Outlet Syndrome
Thoracic outlet syndrome (TOS) is a condition which leads to irritation of the nerves near the shoulder joint causing pain and a host of neurological symptoms into the shoulder, arm and hand. Altered sensation, pins and needles, numbness, weakness and muscle twitching are all symptoms you want to look out for with TOS.
If you have any of the above symptoms and would like to know more about how we can help you relieve them and get back to normal life, then please contact us and ask to speak to a member of our team about how we can help.
There are lots of other common conditions which we see every day in practice which can affect your shoulder. There may post trauma injuries, sporting injuries, post-surgical recovery etc. If you do have any pain/concerns or would simply like to talk more about how we can help please do not hesitate to call us on 01582 318980.
NOTE: The shoulder is also a region which can mask more serious systemic symptoms i.e. from the heart, lungs, stomach etc. Our osteopaths are highly trained to screen for any signs of organic pathology and will refer you immediately if we suspect the symptoms to be of a more serious concern.