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Rotator cuff related shoulder pain

28/7/2020

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The shoulder joint is complex and extremely mobile, at the cost of joint stability. The Rotator Cuff muscles make the shoulder stable and hold it wherever you move the arm. They are four muscles that surround the shoulder joint with each playing a specific role to move and steady the joint. Things can go wrong. Collision, overuse and body posture can each play a role in putting excessive load and strain on any of the muscles of the Rotator Cuff.

The exact symptoms or characteristics of rotator cuff related shoulder pain can widely vary. Symptoms can include dull aching pain and/or tenderness located in the shoulder-joint. Our patients report overhead reaching, reaching behind the back, lifting, and sleeping on the effected shoulder are commonly painful. What’s more, the shoulder feels weak.
Good news is that a structured exercise program is the current gold standard for rotator cuff related shoulder pain (3) with researchers finding that exercise has statistically and clinically significant effects on pain reduction and improving function in patients with rotator cuff related shoulder pain (2)

The key to a good exercise program is a consistent therapeutic dose of exercise and it is important that you continue to do the exercises at home in your own time. This is because research also shows that this does reduces pain and disability in the short term, but it provides similar outcome compared to a shoulder operation (1).
 
We will prescribe you exercises based on your presentation and symptoms. In the early stages exercise consists of gentle loading of the muscles and tissues as well as joint motion exercises. This is to manage the pain whilst setting up the muscles to come back online. As the irritability of the shoulder subsides, your physiotherapy programme will increase the load being put through the shoulder as well as joint motion. Once you achieve the strength and range goals we have set you, we introduce more specific exercises tailored to your work or sport goals (4). This can be anything from high velocity exercises that are perfect for a golf swing or even controlling weight with your hand in the air if your main goal is to just be able to get a jar off the top shelf.

References:
       1.  Manual Therapy (2015), 20(5), 646-656
       2.  Journal Of Shoulder And Elbow Surgery (2013), 22(10), 1371-1379.
       3. The Bone & Joint Journal (2014), 96-B(1), 75-81. 
       4.  Manual Therapy (2016), 23, 57-68. 
Comments

    Luca Scomazzon-Rossi APAM

    Luca graduated from a Bachelor of Physiotherapy with honours and has a background in personal training.

    Jayce Gilbert FACP, APAM

    Clinic director & Specialist Musculoskeletal Physiotherapist* in treatment for back, neck, headache and TMD (Jaw/Face) problems.

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