It can be helpful to narrow your shoulder pain into 5 categories

  1. Rotator cuff muscles
  2. Instability
  3. AC joint
  4. Stiffness
  5. Referred pain

Rotator cuff muscles function to stabilise the shoulder joint while it is moving; which is a very complex task given the large amount of movement available at this joint.  Acute injuries include muscle strains and partial or complete tendon tears.  This may occur from a fall onto your side, a fast reaching action, lifting heavy weights or other trauma.  It is an acute episode of usually immediate pain.

Overuse injuries include tendinopathy.  It is common to experience shoulder impingement (+/- bursitis) with rotator cuff injuries; this is a pinching/painful sensation as you raise your arm.  Pain is often vague around the anterior shoulder and into the upper arm.  It is common to experience pain with overhead activities, sleeping on this side, reaching and lifting and repetitive shoulder movements.  This is the most common shoulder complaint at Capital Clinic Physiotherapy.  See this blog for more information on bursitis.

Instability occurs with problems in the shoulder cartilage (labrum) deep within the shoulder joint. You may experience reoccurring dislocations or feelings of instability.  This is more common in the younger population.

The AC joint is where your clavicle (collar bone) attaches to your acromion (top of the shoulder joint).  Injury to this joint is usually traumatic and involves falling on the point of your shoulder, where pain is pinpoint at the joint.

Shoulder stiffness may be secondary to trauma or surgery, or may occur for no apparent reason in middle age – this is called frozen shoulder (or adhesive capsulitis).  There is an extreme reduction in the range of motion, especially external rotation (turning your arm outwards).

Referred pain can occur from the neck, upper back or surrounding muscles.  There are often a number of factors contributing to the pain, and this referred pain can be present along with the above conditions.

Now that you have an idea of your shoulder diagnosis you are one third of the way there.  The real challenge lies in figuring out how the injury occurred in the first place, what are they contributing factors?  You may think of posture, poor biomechanics, technique, muscle imbalance, weakness, overload, or many more factors.

This is where your Physiotherapist can help you!  They will assess and identify the unique contributing factors that are relevant to your shoulder.  From there, you and your Physiotherapist will work together to achieve your optimal shoulder function.