Shoulder Pain: What to do and Why?

Shoulder pain is widely considered one of the most common areas for injury roughly affecting 20-50% of us on a yearly basis. When looking at the shoulder itself it is easy to see why as it is made up of 5 different joints and allows for almost 360 degrees of motion. Not only that but the use of our arms is of paramount importance for daily life tasks, work environments, sport and exercise and almost anything we can think of.

There are many different potential causes of shoulder pain and it is often a site for chronic pain and sensitisation to develop due to chronic overuse and the significant complexity of the area. Importantly, however, most shoulder pathology/injury is multifactorial and should be treated that way when developing a manual treatment exercise rehabilitation protocol. 

It can be tricky when looking up what to do for shoulder pain as there is a mass of information recommending different exercises and treatments and without a confirmed diagnosis this can often be more difficult. At present the National Institute for Health Care Excellence (NICE) guidelines suggest to keep the shoulder moving as much as possible without causing increased levels of pain so it is vital to keep moving in spite of any injury you might have incurred. The only time where this is not advised is if a break/fracture/dislocation is suspected. They also advise, in most cases, to refer for physical therapy

So…the guidelines say to keep moving as much as possible within a pain-free range, but I don’t know what exercises to do or who to see?

Firstly, the best thing you can do is see a suitably qualified medical professional to help you better understand the injury at hand. They can ensure that it is an injury of musculoskeletal origin or refer you to the right place if there are more severe implications. Once they have confirmed that it is safe to treat they will develop a suitable treatment and rehabilitation protocol. 

The current research on manual therapy for shoulder pain is varied with some articles suggesting it can positively affect outcomes and function whereas others suggesting there is little difference when compared to no intervention. However, exercise rehabilitation is key and at present there is no specific criteria for exercise rehabilitation for shoulder pain. Whilst some programmes have been proposed, such as the Watson Instability Program, it has been noted that general movements of the shoulder to its full capacity work best to help the shoulder recover and specifically movements under some form of resistance whether that be using resistance bands, bodyweight movements or daily weight bearing activities.

In conclusion, if you are experiencing shoulder pain make sure you see a suitably qualified professional, start moving the shoulder straight away when non-musucloskeletal causes have been ruled out, and stay consistent to the prescribed exercise protocol. 

If you have any questions about the above or wish to book an appointment, then please feel free to contact us via our website or through our social platforms.