As musculoskeletal physiotherapists, shoulder pain is one of the most common complaints we see in the clinic. The reason for this is the shoulder is a very complex and unstable joint. It is considered as a ball and socket joint, but a more accurate representation would be a lollipop on a saucer. This analogy gives an indication of how unstable the joint is and the importance of the ligaments, tendons and muscles to support it. This makes the shoulder highly susceptible to injury, both in the professional athlete and the weekend warriors.
One of the most common pathologies we see is that involving the rotator cuff, a group of four muscles (supraspinatus, infraspinatus, teres minor and subscapularis). These muscles act as a pulley system to maintain the humeral head (ball) in the socket (saucer). Common diagnoses given to such a problem may be shoulder impingement, subacromial pain syndrome, rotator cuff tendinopathy, rotator cuff tear, degenerative cuff disease.
The majority of these conditions are successfully managed with conservative measures such as Physiotherapy (we break down our shoulder pain relief exercises in a previous blog post too). A physiotherapist will take an accurate history of what has happened to the shoulder and how the symptoms are impacting on everyday life. This will then be followed by a thorough objective assessment to assess the function and restrictions in the shoulder. Based on these findings it can then be decided on the best pathway of care. The majority of patients respond to physiotherapy alone. A small percentage of patients may need to be referred to an orthopaedic surgeon for a second opinion. This is usually if they have had a traumatic injury or if pain levels are high and are not responding to physiotherapy intervention.
