Shoulder

1. Avoid Overloading Your Shoulders
The rotator cuff muscles which perform an important role in stabilising the shoulder can be easily overloaded, often through overuse. When they become overloaded they stop working effectively, which can often lead to shoulder pain.

Continued overload is the main reason that shoulder patients don't progress, no form of shoulder rehab will be effective if you continue to overload your shoulders.

 

2. Work on Your Rotator Cuff
Strengthening the rotator cuff muscles will make them more resistant to overload. However, strengthening must be approached with caution, particularly when it comes to athletes. The reason for this is that the strengthening exercises that are often used for the rotator cuff muscles can themselves contribute to the overload which caused the pain in the first place.

Traditional rotation based exercises to strengthen the rotator cuff aren't overly effective, they don't carry over well into functional movements. Instead, use exercises to improve the function of the rotator cuff to make them work more efficiently, reducing the loading placed on them and encouraging the shoulder to work more effectively.

Keep an eye on future blogs for exercises to help your rotator cuff!

 

3. Address Any Shoulder Stiffness Issues
If the shoulders are stiff, then more effort will be required during movement to overcome this stiffness. The extra effort required to overcome stiffness in the shoulders increases the chances of them being overloaded.

A common scenario we see is that the rotator cuff muscles become overloaded because the shoulders are stiff. This overload stops them working effectively. Often just loosening up the stiffness within the shoulders combined with exercises to get the rotator cuff muscles working more effectively solves shoulder pain.

 

4. Mobilise Your Thoracic Spine
A recent piece of research identified that having treatment to the thoracic spine (upper back) helps with shoulder pain. The reason for this is that if the thoracic spine is stiff the shoulders have to move further to perform functional activities, particularly if those activities are overhead. This increases the loading on the shoulders leading to.......overload!

If the shoulders are stiff as well, something that is often the case, then the load on the shoulders becomes even greater, more overload = more pain!

 

Using these four tips four shoulder pain to guide your rehab.
Its difficult to know where to start when it comes to shoulder pain, but the diagram below gives an idea of how to structure you rehab.

Four tips for Shoulder Pain - Principles of Shoulder Rehab

One Final Thing to Note
Shoulder pain takes time to recover from, if you have significant shoulder pain, its best to assume that you're in for the long haul. Often its takes 6 months to fully recover, it can even be longer, but equally it can also take less time - everyone is different.

This timeframe doesn't mean that you have to have endless physio, osteo, chiro sessions, or that you aren't going to recover. It just means that you have to be realistic.....and sensible.....and work to a plan (such as the principles outlined above), particularly with regards to overload. Part of the role of a therapist, no matter what their discipline is, is to guide you through a rehab plan, and ensure that you continue to progress.