Shoulder pain can be a highly frustrating issue — it can limit your ability to partake in activities you enjoy, whether that is gardening, playing tennis or sport, or whether you have concerns over clicking, cracking or grinding. The shoulder is the most mobile joint in the body, which makes it susceptible to a range of injuries and overuse conditions.
Our approach is to identify what may be the cause of your pain, address what is contributing to your symptoms, and help you build confidence in movement while developing stability and posture awareness around the shoulder and shoulder blade.
Common Types of Shoulder Pain
Rotator Cuff and Bursitis-Related Pain
The rotator cuff muscles connect the shoulder to the scapula and are responsible for movement of the shoulder joint. Injury can occur from trauma (such as falling on the arm, lifting something heavy or even having a dog tug on a lead) or from overuse in certain jobs or sports. Some people also overload the area because other body parts are weak. These cumulative or traumatic factors can result in tears, tendinopathy or tendon rupture.
It’s important to have a clear picture of the complaint to determine whether conservative, surgical or other interventions are most appropriate.
Instability and Weakness-Related Pain
Shoulder issues can be more complex than other areas of the body because there is often more than one structure involved. There may be an area that’s inflamed and an area that is compensating — along with areas of weakness contributing to the problem. The shoulder joint itself has relatively small bone-to-bone contact, with most stability coming from cartilage, ligaments and the surrounding musculature. The key factor in managing shoulder pain is identifying and strengthening the areas contributing to the issue.
Acute and Sport-Related Shoulder Injuries
Shoulder injuries are common in sports, particularly those requiring overhead activity such as swimming, tennis or throwing sports. Sometimes there can be an initial trauma or knock such as a bump in football, or the injury can come from inadequate loading such as performing high reps or heavy weight on a bench press. We carefully assess for instability, movement patterns and muscular imbalances to give corrective advice. With acute shoulder injuries, imaging is sometimes needed and we will guide you through that process.
Common Causes of Shoulder Pain
The shoulder is a complex joint that needs strong muscular support due to its large range of movement and the weight of the arm. Combined with its role in all day-to-day tasks, it can be vulnerable to injury. Common contributing factors include:
- Overuse: heavy labour, repeated movements in the job, repetitive lifting, poor lifting technique
- History of previous trauma such as fracture, dislocation, or tears of cartilage or rotator cuff
- Weakness of the shoulder musculature from lack of use or a sedentary lifestyle
- Movement patterns that overload the rotator cuff while underusing the dynamic muscles that hold the shoulder together
- Referral of pain from the neck, thoracic outlet or other structures
- Sensitised pain pathways from a long history of shoulder problems
When Should You Seek Treatment?
People typically seek treatment for their shoulders when they experience:
- Weakness in sport or activity
- Pain limiting day-to-day function
- Painful clicking, popping or grinding
- Pain when lying on that side in bed
- Uncertainty whether exercises or activities are helping or aggravating the shoulder
- Other muscles becoming sore as a result, such as the upper trapezius
- A feeling of instability in the shoulder
- A check-over after a recent injury
If you are unsure, an assessment can help clarify what is contributing to your symptoms and how to best move forward.
How We Support Shoulder Pain
Screening and Assessment
We thoroughly screen your complaint and work to understand why it is there, along with the factors that led to your symptoms. We review your shoulder history, prior procedures and what has been effective or ineffective in the past. We then perform strength, range of motion and special testing to determine limitations and movement patterns contributing to your symptoms — and use this as a baseline to assess whether treatment is helping over time.
Manual Therapy
Manual therapy can be useful for managing tightness and stiffness that may be contributing to your symptoms. In shoulder complaints, treatment may be focused on improving mobility through the mid-back, ribs and the shoulder itself. Techniques may include traction, soft tissue massage, dry needling, muscle energy technique and mobilisation. Treatment is variable depending on the issue, pain tolerance and associated symptoms.
Education and Exercises
Our focus is on giving you tools to manage your symptoms and understand your shoulder. For acute complaints this is often a faster recovery timeframe; where the complaint is more persistent or chronic, a longer course of management may be needed. Each shoulder complaint can have different recovery timeframes. We will also discuss your particular needs — whether you are on a time-frame, need to ensure optimal sport performance, or need referral pathways.
When to See Your Doctor First
Some shoulder symptoms require GP or medical assessment first. Please seek urgent medical attention if you experience:
- A shoulder dislocation
- A visible deformity of the shoulder
- Shortness of breath alongside shoulder pain
- Pain in the breast tissue, swelling of the arm, or pain in the lymph nodes
- A history of cancer, unexplained weight loss, night sweats or deep bone pain
If you are uncertain, it is always better to seek a GP assessment first. We can work collaboratively with your GP or specialist once it is appropriate to do so.
Ready to get some answers?
Book an appointment with one of our osteopaths at Flinders Health and Wellness Clinic on the Mornington Peninsula.