by Courtney Letheridge – Physiotherapist
Shoulder pain and/or weakness is a common issue we see at Wisdom Physiotherapy. It’s common for shoulders to become weak or painful, but may not lose significant range of motion. This may be for a number of reasons, including: rotator cuff tendinopathy, bursitis, rotator cuff tears or a combination of these.
The Anatomy
The shoulder is a ball-in-socket joint, allowing for multiple directions of movement. It is stabilised in this joint by 4 rotator cuff muscles. These muscles start on various parts of the shoulder blade, and reach through the joint space and its attachment to the shoulder blade to connect onto the outside of the upper arm bone. This is why people often have referred shoulder pain on the outside of the upper arm, where these muscles insert.
Rotator Cuff Tendinopathy
When these rotator cuff muscles are compressed in the sub-acromial joint space more than usual, it commonly causes tendinopathy (pain, overload and inflammation of the tendon). This typically presents in a person of middle age or else very active people. Common symptoms include sharp, catching and pinching with specific reaching and lifting movements, and trouble sleeping lying on that side. This shoulder usually aches once aggravated, and requires rest or pain relief medication to settle.
Bursitis
Bursitis refers to inflammation of the bursa; a small fluid-filled sack found in every joint of the body to provide lubrication to the joint. Bursa’s allow for smooth movement of joints and provide cushioning for impact absorption. However, if the bursa becomes inflamed due to repeated compression and irritation, it is common to have a sudden onset of pain and significant spike in symptoms. Bursitis can occur concurrently with both rotator cuff tendinopathy or tear.
Rotator Cuff Tear
Whilst having similar symptoms to tendinopathy, a full thickness tear normally occurs as a result of trauma to the area. Characteristically, this may be falling and catching oneself using the affected arm. It is likely to be more restricted by weakness than pain.
How Can Physiotherapy Help?
Your physiotherapist can assess and diagnose what issue you specifically are having with your shoulder and provide reassurance as to your prognosis. They can apply manual therapies including massage, dry needling and joint mobilisations to improve your pain. They will also be able to advise exercises to load and strengthen your shoulder to prevent it becoming a reoccurring issue. It is also important for your physiotherapist to assess other factors that may be contributing to your shoulder, including any pain and stiffness from your neck or upper back areas.
If you are experiencing shoulder pain, don’t put up with it, call us to make an appointment with one of our experienced physiotherapists. Call (08) 6389 2947 or click here to book online.
