Shoulder is one of the most complex joints in the body.

Anatomically, our shoulder joints has very poor joint congruence. The humerus and its socket has very little contact joints - giving the shoulder a lot of mobility but also risks for injury. This is why the shoulder muscles are vital for normally functioning shoulders.

Most of the times, when you are experiencing shoulder pain, this means that your muscles are not strong enough or not working synergistically.

Shoulder injuries often present gradually, for example in those who sustained prolonged work positions or a sportsperson who repetitively overload the arm.

Sudden shoulder pain can also be triggered with traumatic incidents, such as in falls or contact injuries.

Common shoulder injuries:

1. Rotator cuff injury

   • There are four muscles that make up the rotator cuff of the shoulder: Supraspinatus, infraspinatus, subscapularis and teres minor. The tendons of these muscles pass over the shoulder joint. In between the rotator cuff and the bony arch is subacromial bursa (a sack of gel) that provides a smooth surface for tendons to glide over. Rotator cuff impingement syndrome is when the tendons are caught and compressed during shoulder movements. This can occur in people who repeatedly reaching overhead for prolonged periods of time. Shoulder movements can then be painful as impingement causes injury to the tendons and bursa. After addressing pain management, physiotherapy program will focus on muscle strengthening and movement retraining to prevent recurrence.

2. Shoulder instability and dislocations

   • The shoulder joint is the most mobile joint in the body and prone to dislocations. Shoulder dislocations occur commonly in contact sports, such as AFL and rugby. Recurrent dislocations can lead to severe joint instability and impingement syndrome mentioned above. Rehabilitation of shoulder instability typically involves multi-directional rotator cuff strengthening to optimise joint stability.

3. Cervical radiculopathy

   • “A pinched nerve” in the neck is medically referred to as cervical radiculopathy. The nerves that supply the arms branch out from the neck and different structures can intrude along its course - these can be discs between the vertebral spine, inflammatory irritants or “tight” muscles. When neck pain produces tingling, numbness and/or weakness on the arms, physiotherapy treatment may involve nerve “mobilisations” to free up the nerve.

4. Frozen shoulder or adhesive capsulitis

   • Frozen shoulder presents as stiffness and pain in the shoulder, which is caused by the inflamed joint capsule. It can be a very frustrating condition and requires patience for recovery. There is no known cause for the development of frozen shoulder, however, medical conditions such as, diabetes and cardiac disease, seem to be some of its predisposing factors. Rehabilitation for frozen shoulder will aim to maintain shoulder mobility and progress muscle strength. Hydrodilatation procedure may be recommended in adjunct to physiotherapy program.

Shoulder physio is often the first course of treatment for shoulder pain.

When clients visit us for shoulder physiotherapy, Livewell Melbourne-based Physiotherapists are dedicated in helping your body recover in its best way possible. Your physio for shoulder will be evidence-based and tailored according to your priorities of rehab as well as your goals. This is to ensure that your physiotherapy program is relevant and effective for your body.