Shoulder pain is one of the biggest problems that we see in the clinic each week. And that’s no surprise as it’s a significant health issue worldwide.
Shoulder injuries often involve the muscles and tendons of the rotator cuff.
The rotator cuff is a group of four muscles, and its their job to help move your arm and keep your shoulder joint stable. The tendons of these muscles have to do lots of work! This can make them susceptible to getting a bit sore if they get overloaded.
We used to get bogged down in trying to distinguish which part of the tendon was the trouble maker. But now days we use the diagnosis of ‘rotator cuff related shoulder pain (RCRSP)’. Which is a much more simple and easy to understand term.
Being older than 50 years of age, and having a history of prolonged over head movements. are all common risk factors for developing RCRSP
Importantly, RCRSP can be diagnosed by a physiotherapist, and we don’t need any scans to help with the diagnosis. The research has shown us that there is a poor relation between symptoms and MRI findings. In fact, more than 50% of people over the age of 60 will have some level of tear in their rotator cuff and have no pain.
It’s very likely that if you have RCRSP that you will not need surgery. Most people will have better results from a structured exercise program, than they will from surgery.
Things like corticosteroid injections are often prescribed for RCRSP. While they may offer some people short term relief, they are not a long term fix.
So, what can we do?
Removing any aggravating factors should always be the first point of call. Things like massage and dry needling are great at giving short term pain relief.
We can use gentler exercises to help avoid aggravating your shoulder, then build up the exercises as you get stronger.
Once your shoulder has settled down, we can begin to re-introduce previously painful activities. And, for long lasting results, we likely need to build up the strength of the rotator cuff. This will give it the capacity to cope with the demands placed upon it.
There isn’t one best exercise to help with shoulder pain, so your physio will help you find what works well for you.
Keep in mind, it can often take several months for symptoms to improve: this is normal! Trust the process and stick with it. Even if you have had pain for years and years, it can get better.
