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What is causing your shoulder pain?

By: | Tags: | Comments: 0 | April 15th, 2020

Shoulder pain is a very common problem affecting many of us at some point in our lives. One of the main reasons as to why this occurs is due to the shoulder sockets being very shallow to allow for the huge ranges of motion we require for our daily activities.

Due to the shoulder sockets’ shallow nature it is dependent upon a group of muscles known as the rotator cuff. These muscles make up the capsule which surrounds the ball and socket of the shoulder and are the key to the ball being well-centered within the socket, as well as ensuring stability of the joint throughout movements. The rotator cuff muscles are supported in part by a small ring of cartilage around the socket known as the labrum. As the socket of the shoulder is part of the shoulder blade, and the four rotator cuff muscles all attach onto the shoulder blade itself, the entire ball and socket is also affected by the position of the shoulder blade. As this in turn is a floating bone, reliant on muscles to tether it to our rib cage, the position of the shoulder blade can vary dramatically depending on an individual’s posture, work and hobbies, leading to muscle imbalances.


The first common shoulder issue occurs when the muscles at the front of the shoulder become stronger than those at the back of the shoulder. The imbalance in the front and back groups of muscles leads to the ball riding forward and upward within the socket and compressing into the bony shelf  above the ball (the Acromion) and socket squashing muscle tendons and bursae. This, in turn, causes pain when raising the arm in front and to the side (around shoulder height) – a condition known as Shoulder Impingement. 



Besides posture and habits, muscle imbalances can also occur due to trauma to one or more of the rotator cuff muscles which, in turn, will cause muscle wasting and weakness from disuse during the initial phases of repair. These injuries can be accurately diagnosed by a series of diagnostic tests performed by a Physiotherapist, negating the need for an MRI, and with the correct diagnosis a tailored exercise plan can be created to ensure full recovery.

In more severe cases a rotator cuff muscle can rupture, in which case surgery could be needed, however this is often dependent on the athletic requirements. Following a surgical repair, rehab physiotherapy is just as vital to ensure a return of optimal balance within the rotator cuff muscles.


What a pain in the neck!

It is also important to be aware that shoulder pain could be radiating from a neck problem as the nerves in the neck travel through the shoulder and down to the fingertips, meaning that if the nerve is compressed in the neck, the pain can radiate further down the path of the nerves. So the second most common cause of shoulder pain is actually related to neck issues!

Neck issues could be the true cause of your shoulder pain, if:
⦁ Pain radiates down past the elbow into the hand;
⦁ Pain radiates down your arm when you move your neck;
⦁ Pain persists at rest;
⦁ Pain feels very sharp;
⦁ You get a pins and needles/tingling sensation along the arm.


The third most common shoulder issue is know as Frozen Shoulder, which you can read more about HERE.


Frequently Asked Questions related to Shoulder Pain:

1) I recently injured my shoulder and it is sharp and painful, what should I do?

⦁ Start with standard pain relief such as paracetamol and ibuprofen if you do not have and conditions contraindicating the use of these medications;

⦁ Use ice on the site of the discomfort: for best outcomes, try 10 minutes on, 10 minutes off, 10 minutes on again a few times a day;

⦁ Try to maintain movement in the shoulder, even if it means you do less than normally, listen to the shoulder and don’t push into the pain;

⦁ Consider going to A&E if:
– The shoulder looks unusual OR
– If you can’t move it more than 45 degrees up or out to the side OR
– The pain is severe;

And finally:

⦁ Seek a Physiotherapist if the pain is not greatly improved within the first 2-3 weeks.


2) My shoulder has been achey and problematic for a while but it came on gradually, what should I do?

⦁ Seek a full Physiotherapist assessment: a detailed series of testing is the best way to correctly diagnose the issue and therefore accurately prescribe the treatment.

⦁ Try heat to reduce local muscle aches and pain.

⦁ For the majority of shoulder aches, postural loading and posterior chain weakness is a key part of the issue, try starting off with this simple exercise and see if it helps your symptoms within a few days of practice. Try 3 sets until the shoulder fatigues, with 1 minute rest between sets, 2 times per day. You can easily use a tin of food or medium bottle of water as resistance for this exercise.



If you would like to discuss your shoulder issue further with one of our expert Physiotherapists, please call 01992 451849 OR if you would like to book an initial assessment and treatment session you can choose a date and time which is most convenient for you by using our self booking portal.

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