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Shoulder Pain Treatment


Causes of Shoulder Pain

Shoulder pain and stiffness can be very debilitating. We rely upon our shoulders for everyday activities – shopping, dressing, washing ourselves and looking after our children and pets. The shoulder is a very shallow ball and socket joint – this is what gives the shoulder its large range of movement. However, with such a gain in movement, we naturally lose stability. The shoulder is particularly prone to injury and dysfunction because of its unique anatomy.

Some of the biggest shoulder problems include:

  • Frozen shoulder
  • Rotator cuff problems
  • Arthritis
  • Acromioclavicular joint problems
  • Labral tears
  • Pain referred from the neck or thorax
  • Muscular trigger points

Accurate diagnosis of the problem causing the shoulder pain is important when developing a treatment and rehabilitation plan.

Shoulder Injuries

Shoulder injuries are common in contact sports such as rugby and American football, as well as in non contact sports where falls onto the shoulder can result in shoulder or acromioclavicular damage.

The most common causes of shoulder injuries inclues:

  • repetitive lifting overhead
  • overhead throwing sports
  • contact sports/collisions
  • falls and direct trauma

Shoulder Pain Treatment

The type and cause of shoulder pain will direct the type of treatment offered. Most treatments will involve gentle movements (active and passive), traction and soft tissue treatments to the shoulder area. Heat may be advised for tender trigger points which aren’t suitable for more direct work. Exercise and postural advice will be given to help with shoulder movement, range and dynamic control. An osteopath will also direct attention to the spine near the shoulder to look for dysfunction which may be contributing to the problem. For example, a very stiff spine won’t rotate very well, which will force a reaching arm and shoulder to have to work harder and create more compression in the front of the shoulder. Helping improve mobility in the spine will reduce this influence upon shoulder movement, making your recovery faster and longer lasting.

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Frozen Shoulder

Frozen shoulder, or adhesive capsulitis, is a painful condition affecting 2-3% of the adult population, and usually affects more women than men.  It often starts with shoulder pain when moving the arm and gradually progresses to stiffness and a very limited range of motion.  The shoulder pain and stiffness can be severe, particularly when you try to raise your arm up to your side to make certain kinds of movements that are particularly  important for daily living: reaching for an object on a shelf, doing up a bra strap, or putting on a coat.

Frozen shoulder occurs when the tissue capsule that houses the tendons, bones and ligaments that make up the shoulder begins to thicken.  When the joint capsule tightens, it squeezes the bundle of bone, ligaments and muscles so that they cannot move very well.Osteopathy for Frozen Shoulder The joint membrane is irritated and does not lubricate the joint properly.  All of this, possibly combined with a neurological change within the joint, are what causes the pain and stiffness you feel.

Often there is no ’cause’ for a frozen shoulder however they are more common in

  • people over 50
  • smokers
  • people with diabetes or cardiovascular disease
  • people with other connective tissue problems (Dupuytren’s Contracture)
  • people who have had a trauma to the shoulder (falls, surgeries, local radiotherapy)
  • people with a previous history of frozen shoulder

Frozen shoulder has three main stages:

Phase 1: Freezing – night pain and painful movements that become harder to do as the shoulder capsule clamps down on the joint

Phase 2: Frozen – less pain at night, but extreme pain when moving suddenly, and very restricted movement

Phase 3: Thawing – movement begins to return as the capsule begins to thin and relax

Left alone, frozen shoulder can take an average of 34 months to pass. That is almost 3 years!

Osteopathic treatment, especially the Neil-Asher Technique, can be very effective in treating frozen shoulder. I am a Neil Asher Master Practitioner – an excellent non surgical alternative to helping frozen shoulder.

Rotator Cuff Problems

The rotator cuff is a group of muscle tendons which provide support and contribute to movement of the shoulder. Because the shoulder is so mobile, one of the key functions of this group of muscles is to help hold the ball of the shoulder in it’s socket while other muscles provide larger movements.

Main causes of rotator cuff injury include:

  • overhead work
  • repetitive overhead throwing
  • degeneration or ‘wear and tear’ of local joints
  • sports trauma

Rotator cuff problems can cause not only pain but shoulder instability, making other injuries more likely. A comprehensive rehabilitation programme is best for asymptomatic shoulder instability.

Shoulder Blade Pain

Many people develop pain in the shoulder blade area, especially between the shoulder blade and the spine. This can be one sided or it can be felt on both sides. This kind of pain is nearly always caused by muscle spasm of levator scapulae, rhomboids or the thoracic erector spinae muscles. It may not be the shoulder itself which started the pain cycle, but commonly is a result of the body compensating for an irritated rib joint (costovertebral joint) or a joint between the vertebrae in the back. When these joints are irritated or stiff, as is often the case with desk bound workers, they can cause a reflex spasm in the muscles attaching to them – many of which can refer pain to the shoulder blade or contact the shoulder blade directly. These kinds of shoulder blade area problems can cause compensations in the neck and bring on headaches. It is always better to treat this kind of pain promptly than to let dysfunctional muscle recruitment patterns set in.


Get your Shoulder Pain checked and treated today!

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