The “Problem” Shoulder: Never too late to seek treatment – Kate Young, Physio

Have you ever had a bout of mild, achy shoulder pain of unknown cause that lasted a few weeks that just seemed to “go away”, only to have it return a few months or years later out of the blue? Perhaps this pattern has repeated itself many times over? Many clients present to us with this kind of history and feel badly for not having sought out help sooner. Never feel guilty for having ignored pain, because we all do it at some point….even us as physiotherapists!

The Rotator Cuff and Impingement 

Problems with the rotator cuff muscle group is one of the most common causes of shoulder pain. General overuse and/or performing repetitive shoulder movements in poor positions, from slouching while using a computer to throwing a baseball with incorrect form, can cause the tendons of the rotator cuff muscles to become impinged, or entrapped, under a naturally bony part of our shoulder (called the acromion) which overlies them. Over time mechanical impingement can cause wear and tear on the rotator cuff tendons and eventually inflammation and pain. This problem can be accelerated via muscle overuse along with imbalances in the strength of the rotator cuff muscles and scapular stabilizers (a.k.a. shoulder blade muscles), which are intimately linked to shoulder function. Even the flexibility of your upper back, i.e. thoracic spine, is an important factor for healthy shoulder function, especially during overhead shoulder movements.

Why does the pain return?

If one rests a painful shoulder, usually the acute inflammation will dissipate and pain will cease within a couple of weeks. However, the underlying causative factors usually remain unchanged. This is why too often than not the pain may seem to “mysteriously” return. If left unchecked these issues can even result in rotator cuff tearing, which is surprisingly common: the incidence of partial- to full-thickness rotator cuff increases substantially after the age of 50 – even in those who have never had symptoms. Thus, pain can arise from a myriad of other factors effecting shoulder function, including strength, flexibility and biomechanical issues that are modifiable.

Physiotherapy – never too late

This is a perfect situation to seek help from a physiotherapist, no matter how mild or severe the shoulder pain may be. By analyzing your movement patterns, relevant joint biomechanics, muscle tension and strength, a physiotherapist will identify the underlying causes of the pain. Following this, a plan will be created and implemented to prevent worsening, and hopefully reverse, any muscle or tendon damage. We will guide you in terms of how to correct any movement problems, what and how to strengthen and stretch, and provide manual therapy and pain management as needed. As a two-way partnership we will always be with you along the path to pain-free activity.



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