Is constant shoulder pain affecting your sport performance, work or daily life? Find out how non-traumatic shoulder problems can occur and how you can manage your pain and injury.
Shoulder pain can arise in a couple of ways:
Traumatic Shoulder Pain : From a specific moment or trauma incident, such as a heavy fall, poor tackle or an accident.
Non-traumatic Shoulder Pain : can gradually develop without any specific trauma, and usually relates to a group of muscles and tendons in the shoulder known as the rotator cuff.
Imaging scans, such as MRI or Ultrasounds may report findings such as Supraspinatus, Infraspinatus, Subscapularis or Teres Minor (Rotator cuff tears), Rotator Cuff Tendonitis/ Tendinopathy, and Subacromial Bursitis.
Interestingly, many of these findings can be found in people who experience no pain as well as those who do!
Managing non-traumatic shoulder pain is done so in a scaled manner - starting with more conservative management options, aiming to avoid more invasive interventions such as injections or surgery.
A high-quality conservative management plan may include:
progressive exercise program aimed to build capacity and tolerance in the shoulder
education about managing or reducing painful tasks of daily life
manual therapy and taping for pain relief
Cortisone / cortico-steroid injection may be considered for pain management if initial response to a conservative approach is not helping. There are pros or cons to consider before proceeding with an injection and these are best discussed with your doctor or health professional.
A long-term exercise program is still an important management strategy following an injection based on research findings.
What about Surgery?
Orthopaedic specialist assessment and advice regarding management options is an important component of shoulder care.
For rotator cuff injuries specifically, there is some evidence to suggest surgery may not improve shoulder function or pain compared to progressive exercise therapy, however surgery may be a viable option for some cases (Karjalaninen et al, 2019).
Please note, research should be interpreted with care. Surgery can be helpful for people who do not improve with conservative management strategies and again is best discussed with your doctor, specialist or health professional.
What is the Right Plan for me?
For more information or an individual assessment plan, please see one of our skilled clinicians.
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Or call our clinic at 02 4647 3373
Lewis, Jeremy (2016). Rotator cuff related shoulder pain: Assessment, management and uncertainties. Manual Therapy, (), S1356689X16000400–. doi:10.1016/j.math.2016.03.009
Pieters, Louise; Lewis, Jeremy; Kuppens, Kevin; Jochems, Jill; Bruijstens, Twan; Joossens, Laurence; Struyf, Filip (2019). An Update of Systematic Reviews Examining the Effectiveness of Conservative Physiotherapy Interventions for Subacromial Shoulder Pain. Journal of Orthopaedic & Sports Physical Therapy, (), 1–33. doi:10.2519/jospt.2020.8498
Karjalainen, Teemu V; Jain, Nitin B; Heikkinen, Juuso; Johnston, Renea V; Page, Cristina M; Buchbinder, Rachelle (2019). Surgery for rotator cuff tears. Cochrane Database of Systematic Reviews, (), –. doi:10.1002/14651858.CD013502