Shoulder Injuries

Useful Information

In patients with chronic shoulder pain there are usually multiple contributing factors. These factors involve:

• cervical and thoracic joint dysfunction,
• muscle tightness and weakness,
• trigger points, and  shoulder joint abnormalities.

How can we help?

If you are unable to travel to one of our practices due to lack of mobility or pain, we are available to come to your place of residence and carry out physiotherapy treatment in the comfort of your own home.

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Shoulder Overuse, Instability & Stiffness

Injuries to the rotator cuff (RC) muscles and tendons may be acute, chronic or acute on chronic. Acute injuries include muscle strains or tendon tears. Overuse injuries include tendonopathies and bursitis. An acute on chronic injury is a complete RC tendon tear in a previously degenerative tendon.

Pain resulting from instability may present anywhere around the shoulder. Instability is the key sign in patients who have sustained recurrent dislocations or subluxations. Shoulder dislocations are important to rehabilitate as they have a very high reoccurrence rate and are associated with tearing of the cartilage around the edge of the socket and shoulder fractures. Damage to these structures causes further mechanical instability and each dislocation can cause further damage to the shoulder.

Shoulder stiffness can be a result of trauma including surgery, or from injury to the nearby nerves. It can also occur spontaneously in middle age for no apparent reason-this is known as adhesive capsulitis or a frozen shoulder.

AC joint pain is common following a direct fall onto the tip of the shoulder and is one area where the pain is localized.

It is common for pain to be referred to the shoulder from the cervical spine (neck), thoracic spine (upper back) and their associated muscles. In patients with chronic shoulder pain there are usually multiple contributing factors. These factors involve cervical and thoracic joint dysfunction, muscle tightness and weakness, trigger points, and especially shoulder joint abnormalities such as RC tendinopathy and /or instability.

Rotator cuff tendons are commonly operated on during shoulder reconstructions and require a comprehensive and progressive exercise program for optimal rehabilitation.

Shoulder Pain Treatment

Physiotherapy management will involve establishing a provisional diagnosis based on our specific shoulder assessment. We then provide an activity modification plan, strengthening and stretching program, and hands-on-therapy involving soft tissue release and mobilizing tight and painful joints around the shoulder and spine. We do not belief in the “recipe” approach to rehabilitation protocols. Our protocols are individually customized and evidenced based to ensure rapid return to normal pain free function and activity.