James Grigg
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Shoulder pain

The shoulder joint is the most mobile joint in the body. It is a ball and socket joint just like the hip joint, however the shoulder socket is much shallower than that of the hip. As a result, the shoulder sacrifices a little in stability in favour of mobility. The range of movement available at the shoulder is also greatly influenced by the motion of the shoulder blade (scapula). Without this extremely mobile bone, the range of movement available at the shoulder would be greatly reduced. Therefore, any shoulder blade restriction will immediately impact on the shoulder.

In a lot of shoulder pain cases, there is nothing actually wrong with the shoulder, and the reason for the pain is due to a trapped nerve in the neck. In fact, the majority of shoulder related problems we see in clinic are due to neck problems. The person may or may not have any symptoms in the neck, but they are often amazed at how some simple treatment to the neck can free the symptoms in the shoulder. After examining the shoulder, the most appropriate treatment can be implemented.

Some of the common shoulder injuries we see are outlined below. 



Rotator cuff injury

There are four muscles that make up the rotator cuff muscle group. All of them directly attach from the shoulder blade to the top of the arm bone (humerus). Rotator cuff injures can happen with direct trauma or can gradually come on due to repeated movements. They will classically cause pain with shoulder movement, in particular, raising the arm straight out in front or to the side of the body.

The rotator cuff muscles are deep within the shoulder and help to stabilise, as well as move the arm and shoulder complex. It can be a very painful condition to treat especially if there is a significant tear. Most of the time, people come to the clinic with an overworked rotator cuff type injury, i.e. a repetitive strain type injury leading to a "tendinopathy" (wear and tear damage to a tendon). Obviously we need to focus treatment modalities to help heal the tissue, however as always, the damage has happened for a reason. This might be due to muscle imbalance, joint mechanics or even spinal mobility issues.

The treatment to the actual rotator cuff muscles will often include mobilisation techniques, soft tissue massage, strengthening, electrotherapy and movement therapy. Actually addressing why the issue happened in the first place will depend on what we find in the assessment. The good news, most rotator cuff tendinopathies respond very well to conservative treatment. Severe tears on the other hand may require surgery.    

Here at the clinic we have a close relationship with the Centre for Ultrasound Studies located in Bournemouth, and we are able to refer our clients directly to the clinic to have a scan. This process normally takes up to 7-10 days, with results delivered a few days later.


Trapped / pinched nerves

As already mentioned above, shoulder pain can often be as a result of a pinched / trapped nerve that runs in-between the vertebrae in the neck. It is common for the person not to actually feel any pain in the neck and just feel pain in the shoulder. Quite often a feeling of "generalised" shoulder pain is reported with no areas of tenderness. The person may also describe the pain as "random", i.e. it can be fine one day, but then be extremely painful for no apparent reason. 

Learn more about neck problems

The majority of shoulder pain we see in clinic can be resolved from restoring full range of movement to the neck and shoulder blade