Phone: 045 874682

Shoulder Pain

Treatment of shoulder pain by Physio Naas & Newbridge. Chartered Physio & Chiropractor

Ross Allen is Ireland’s only dual-qualified Chartered Physiotherapist & Chiropractor.

 

 

 

 

 

 

 

 

 

                                         KFM Radio Interview


             Ross discussing Shoulder Pain. Press Play Below:

Causes of shoulder pain with treatment at the Physio Clinic - Naas & Newbridge. Chartered Physio & Chiropractor


Shoulder Pain

The shoulder joint has the largest range of motion of any joint in the body. Due to the exceptionally large range of motion, there is a resultant reduction in joint stability. This reduction of stability can predispose the shoulder to injury when the shoulder is exposed to force such as with rugby or other contact or racket sports. An intricate network of tendons, muscles, ligaments and bony articulations provide joint stability. Any injury or overload of these structures can give rise to pain or instability of the shoulder. Many cases of shoulder pain are multidimensional in nature. For example, if there is instability present then this may give rise to tendon or muscle overload & eventually cause significant shoulder pain..

Potential causes of Shoulder Pain Include:

  • Fracture or dislocations
  • Tendonitis or capsulitis
  • Osteoarthritis or rheumatoid arthritis
  • Cervical disc herniation
  • Thoracic outlet syndrome (compression of the nerves &/or blood vessels that supply the shoulder & arms)
  • Vascular disorders
  • Referral from organs such as the heart, liver, gallbladder, lungs & diaphragm.

The alignment of the scapula (shoulder blade) is commonly discussed as being one of the primary determinants of shoulder function. Modern Western living with its emphasis on prolonged sitting & slouched postures can give rise to pour scapula alignment and muscular control.

Shoulder Pain in Elderly

In the elderly population, the accumulation of years of degenerative change can often create an impingement & give rise to pain with end range shoulder activities. This will require a number of months to address & requires close adherence to a rehabilitation programme from the patient. Another frequently encountered condition in the elderly is adhesive capsulitis where a progressively increasing pain & limitation of movement develops.

Physiotherapy Management of Shoulder Injury

If there has been a history of severe trauma and clinical findings warrant further investigation then x-rays or MRI scans may be ordered to identify the source of shoulder pain. Suspected fractures & acromioclavicular joint separations are best diagnosed with x-ray while rotator cuff tears are best diagnosed using MRI scans or contrast arthrography.

Given the complexity of the shoulder joint complex there can often be multiple drivers of shoulder pain.  Management of shoulder pain will be guided by the severity of symptoms.  A progressive rehabilitation program is vital to restore normal strength and shoulder function.

Treatment modalities for shoulder pain will include:

  • Myofascial release techniques
  • Dry needling
  • Joint mobilisation
  • Stretching
  • Strength training to restore normal muscle activation patterns
  • Proprioceptive training (improving shoulder joint position sense)

Activity modification (for example athletes who have undergone shoulder dislocation are at greatest risk of further dislocation for two months after injury).

Manual Therapy for Shoulder 

Schmerz et al. (2016) analysed the impact of manual trigger point compression therapy in patients with chronic shoulder pain. The authors found that manual trigger point therapy was significantly more effective when compared with sham therapy.

Laser Therapy Not Effective

A review of the existing research by Haik et al. (2016) reported strong evidence for the lack of beneficial effects of  low-level laser, ultrasound and pulsed electromagnetic field (PEMF) on pain, function or range of motion in the treatment of shoulder pain. There is moderate evidence to no benefits with taping in the short term.

References:

Schemer et al. (2016). Manual trigger point therapy of shoulder pain : Randomized controlled study of effectiveness.
http://www.ncbi.nlm.nih.gov/pubmed/27295296

http://www.ncbi.nlm.nih.gov/pubmed/27288517

To book an appointment for your shoulder pain at the Physio Clinic Naas & Newbridge Call:
(045) 874 682

or email us at info@physioclinic.ie

 

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