Opinion

Physio: Shoulder pain that won’t go away

Have you ever just tweaked your shoulder doing something innocuous, and waited for the pain to go away, only for it to just hang around?

Do you get a sharp pain in your shoulder or upper arm when you reach up or behind yourself? Is it uncomfortable to lie on your side in bed at night?

If so, there is a chance you may have shoulder impingement, a condition where one of the rotator cuff muscles has been damaged and is continually pinched when the shoulder is moved in certain positions.

The shoulder is such a mobile joint in our body and has a large range of motion so that we can reach our hands into lots of positions in order to go about our daily business such as brushing our hair, tucking our shirt in, or reaching up to the top of a cupboard.

What enables us to control all of these movements is a group of four muscles collectively known as the rotator cuff. The rotator cuff muscles originate from the shoulder blade and work in fine balance to provide the control that enables us to move our hands into such a large range of positions.

Shoulder impingement occurs when this balance is lost, causing uncoordinated movement; resulting in one of the rotator cuff tendons being repeatedly pinched between two bones every time the shoulder is moved into a certain position—commonly overhead or behind you.

It is usually experienced as a quick sharp jolt of pain that can often be felt down the arm. When the arm is moved back into a comfortable position, the sharp pain will usually resolve and you can be left with a dull ache in the area. This pattern of pain will continue until the correct movement pattern has been restored to the shoulder. This is where a physiotherapist can help, by identifying what has caused the tendon to be pinched and providing a way to correct it.

Once this has been done and the shoulder is moving in such a way as to prevent further aggravation of the tendon, a physiotherapist can use a variety of techniques to promote healing, and improve the strength of the tendon.

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