Shoulder pain, injuries and surgery is something we see very commonly with our active patients, as they are always pushing themselves that little bit extra!
As the shoulder joint is a complex one, with large ranges of movement and limited stability, certain structures are likely to become irritated with overhead sport or non-optimal movement patterns.
Injuries can happen following a sudden lifting, pulling or arm above head movement, or gradual onset of pain from repetitive lifting, age-related changes and lots of movement with poor biomechanics.
In most cases, if you have shoulder pain, suffer a soft tissue injury or have had surgery to the shoulder, you will need to do the right rehab exercises in a specific program as well as manual physio treatment to improve the joint range of movement and muscle stiffness.
Rotator Cuff Injuries
The rotator cuff is a group of four muscles originating at the back of the shoulder that moves, guides and gives stability to the shoulder joint.
Following lifting, pushing or pulling activity, tendinopathies can develop in one or more rotator cuff tendons.
Full or partial tearing can also then occur over time or as a result of trauma.
Pain commonly increases with lifting activities, (especially with the arm outstretched or above the head),
or lying on the affected side and is localised in the side, back or even the front of shoulder.
Symptoms also include weakness when attempting to reach for an object in front or to the side and pain with pressing and pushing weights.
Impingement and Bursitis
Shoulder impingement is a condition related to biomechanical instability, weaknesses and neuromuscular dysfunction where soft tissue structures are intermittently ‘impinged’ and trapped during shoulder movements.
The most common symptoms is an arc of pain with movement of the shoulder above the head.
This can cause injury to the tendons and surrounding structures such as the inflammation in the bursa (bursitis).
This condition can occur traumatically like during a fall, however it commonly arises when the shoulder is moved repetitively in an non optimal fashion, due to weakness or tightness in the shoulder.
Dislocations and Fractures
Shoulder dislocation commonly occurs through sport or activity, when falling on an outstretched hand or by direct impact from another person or object.
Severe pain usually follows and it can radiate down the arm, as well as ongoing apprehension of ‘popping out’, muscle spasm and sometimes pins and needles or numbness.
Physiotherapy for this condition is crucial to reduce pain and restore movement, as well as strengthen the muscles around the joint to prevent further dislocation.
We also commonly see humeral and collar bone fractures, with some requiring surgery and post-operative Physio and rehab.
AC Joint and Frozen Shoulder
Sprains, inflammation and AC joint dislocations are surprisingly common, with some grade 3 ligament ruptures requiring stabilisation surgery for the AC joint and subsequent Physiotherapy and careful strengthening.
Frozen shoulder (adhesive capsulitis) can arise spontaneously with severe loss of range into external rotation, abduction and flexion along wih pain and inflammation in the joint capsule. This can happen following a previous shoulder injury or as a complication from shoulder surgery. All our patients do a lot better through the 'thawing phase' from having specific joint mobilisation and rehabilitation programming.
Reconstructive Surgery
Surgery for the shoulder can be a big decision and involve extensive rehabilitation to return to sport and exercise.
It may involve repair of the rotator cuff tendon if the tear is large, as well as bursectomies, bicep tenodesis, and labral repairs.
Luckily, post-operative rehab is one of our fortes.
We specialise in restoring mobility, strength and conditioning for tendon repairs, SLAP and labral repairs, as well general arthroscopic surgery and shoulder replacements, to enable a successful recovery of your shoulder and return you to training safely and effectively.
You will be guided through an extensive and complete rehabilitation program coupled with hands-on Physiotherapy during the recovery phase.
