As musculoskeletal physiotherapists, shoulder pain is one of the most common complaints we see in the clinic. The reason for this is the shoulder is a very complex and unstable joint. It is considered as a ball and socket joint, but a more accurate representation would be a lollipop on a saucer. This analogy gives an indication of how unstable the joint is and the importance of the ligaments, tendons and muscles to support it. This makes the shoulder highly susceptible to injury, both in the professional athlete and the weekend warriors.

One of the most common pathologies we see is that involving the rotator cuff, a group of four muscles (supraspinatus, infraspinatus, teres minor and subscapularis). These muscles act as a pulley system to maintain the humeral head (ball) in the socket (saucer). Common diagnoses given to such a problem may be shoulder impingement, subacromial pain syndrome, rotator cuff tendinopathy, rotator cuff tear, degenerative cuff disease.

The majority of these conditions are successfully managed with conservative measures such as Physiotherapy (we break down our shoulder pain relief exercises in a previous blog post too). A physiotherapist will take an accurate history of what has happened to the shoulder and how the symptoms are impacting on everyday life. This will then be followed by a thorough objective assessment to assess the function and restrictions in the shoulder. Based on these findings it can then be decided on the best pathway of care. The majority of patients respond to physiotherapy alone. A small percentage of patients may need to be referred to an orthopaedic surgeon for a second opinion. This is usually if they have had a traumatic injury or if pain levels are high and are not responding to physiotherapy intervention.

One of the key components in shoulder rehabilitation is specific physiotherapy exercises for shoulder and arm pain. The importance of improving muscle patterning and strength in the shoulder complex is key in reducing pain and preventing any re-occurrence of symptoms in the future. Below are a few basic exercises that can help assist with shoulder and arm pain.

Bilateral Wall Slides- place hands shoulder-width apart, step forward with your right leg and slide hands up the wall. Work within a pain-free range. As you bring the arms down step back with your leg to the starting position. Repeat with the left leg. Aim to do between 8-12 repetitions, maximum three sets. Movement should be pain free.

Four-Point Kneeling Series- knees should be under hips and hands under shoulders. Ensure equal weight distribution through the hands and gently draw shoulder blades into your back pockets. Level one would be alternating arm slides, level two alternating leg sidles and level three would be contralateral arm and leg slides (superman). Aim to do 5-10 repetitions, 2-3 sets depending on control and pain levels

Proprioceptive Ball Bounces- standing with feet hip-width apart. Arm in an abducted position between 70-90 degrees (pain dependent). Bounce the gym ball repeatedly off the wall. Level one would be bouncing the ball in the same spot. A progression would be to try and bounce the ball around in a clockwise position. Speed should remain the same and control essential. This exercise works on proprioception and reaction speed. The challenge is to see how long you can do it with good form!

Are you suffering from a shoulder injury? Please feel free to contact us to make a booking here.