Welcome to our Shoulder Patient Resources page.
Whether you're dealing with shoulder pain or want to improve your shoulder health, you'll find valuable information and practical advice here.
Video Resources
Click on the videos below for access via YouTube to expand your shoulder knowledge:
- Rotator Cuff Shoulder Pain: Exercise is as effective as surgery
(https://www.youtube.com/watch?v=5bUf9VcYLmI) - Understanding pain
(https://www.youtube.com/watch?v=qEWc2XtaNwg) - What happens inside your body when you exercise?
(https://www.youtube.com/watch?v=wWGulLAa0O0) - 23 and 1/2 hours: What is the single best thing we can do for our health?
(https://www.youtube.com/watch?v=aUaInS6HIGo) - What's the Best Diet? Healthy Eating 101
(https://www.youtube.com/watch?v=fqhYBTg73fw) - 90:10 The Single Most Important Thing You Can Do For Your Stress
(https://www.youtube.com/watch?v=I6402QJp52M)
Understanding Your Shoulder
Shoulder Anatomy
Your shoulder is a complex joint that allows for a wide range of motion. It's made up of:
- Bones: Humerus (upper arm), scapula (shoulder blade), and clavicle (collarbone)
- Muscles: Large surface muscles and smaller deep muscles
- Rotator cuff: Four muscles and their inter-woven tendons that stabilise and move the shoulder
- Labrum: A ring of cartilage that deepens the shoulder socket
- Bursa: Fluid-filled sacs that reduce friction during movement
Key muscle groups:
- Deltoid: The large, outer "power" muscle that lifts your arm in various directions. It's supported by the pectoralis major (chest muscle) and muscles connecting the shoulder blade to the trunk (serratus anterior and trapezius).
- Rotator Cuff: A group of four smaller, deep muscles and their tendons that wrap around the shoulder joint like a cuff. They include:
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
The rotator cuff keeps your upper arm bone (humerus) centered in the shoulder socket. These muscles work quickly, even before visible arm movement, ensuring the joint stays safe and movements are effective.
How it all works together:
- The shoulder muscles work in harmony, allowing for thousands of coordinated movement patterns.
- Your brain can rapidly adjust these patterns to protect your shoulder and optimize efficiency.
- Regular movement of both the shoulder and the whole body is crucial for maintaining and improving shoulder health.
This intricate design allows your shoulder to perform a wide range of motions while maintaining stability. Understanding this anatomy helps appreciate why proper care and exercise are essential for shoulder health.
Common Shoulder Conditions
Understanding the various shoulder conditions can help you better manage your shoulder health. Here are some of the most common conditions:
- Rotator Cuff Related Shoulder Pain
- One of the most common causes of shoulder pain, especially in middle-aged and older adults
- May develop gradually or due to an accident or injury
- Symptoms include:
- Pain when lifting the arm or reaching behind your back
- Pain that may extend down the arm
- Weakness when lifting or rotating the arm
- Stiffness in the shoulder
- Frozen Shoulder (Adhesive Capsulitis)
- Causes severe pain and stiffness in the shoulder
- Often has two phases: (1) pain worse than stiffness, (2) stiffness worse than pain
- More common in people aged 35-60 and those with diabetes
- Symptoms include:
- Gradually increasing pain and stiffness
- Difficulty with daily activities like dressing or reaching overhead
- Pain that may disturb sleep
- Shoulder Osteoarthritis
- Results from the joint trying to heal itself, leading to changes that may or may not be painful
- More common with older age or previous shoulder injuries
- Symptoms include:
- Pain that increases with activity and improves with rest
- Stiffness, especially in the morning
- A grinding sensation when moving the shoulder
- Shoulder Instability
- Can result from a dislocation, subluxation, or increased flexibility
- Symptoms of instability include:
- A feeling that the shoulder might 'pop out'
- Pain when moving the arm in certain positions
- Weakness or loss of movement
- Acromioclavicular (AC) Joint Pain
- Often caused by falling directly onto the shoulder
- Can be acute (due to recent injury) or chronic (persistent from past injuries)
- Symptoms include:
- Pain at the top of the shoulder
- Pain when reaching across the body or lifting the arm overhead
- Other Conditions
- Fractures: Can affect the shoulder blade, collarbone, or upper arm bone
- Nerve Injuries: Can cause weakness, numbness, or tingling in the arm or hand
- Referred Pain: Shoulder pain may sometimes originate from neck or upper back issues
It's important to note that diagnosing the exact cause of shoulder pain can be challenging. Many people without shoulder pain can have tissue changes visible on imaging (like partial rotator cuff tears) without experiencing symptoms. Therefore, a thorough assessment by a healthcare professional is crucial for proper diagnosis and treatment.
If you suspect you have any of these conditions, consult with a physiotherapist or your GP. They can provide a proper assessment, recommend appropriate treatments, and determine if further investigations like X-rays or MRI scans are necessary.
Pain Management
Why Does My Shoulder Hurt?
Shoulder pain is complex and can be influenced by various factors:
- Nociceptive Pain:
- Caused by actual or potential tissue damage
- Can be acute (recent injury) or chronic (long-lasting)
- Examples: Rotator cuff tears, osteoarthritis, fractures
- Neuropathic Pain:
- Results from damage or dysfunction in the nervous system
- Can cause burning, shooting, or electric-like sensations
- Examples: Nerve compression, brachial plexus injuries
- Nociplastic Pain:
- Occurs when the nervous system becomes overly sensitive
- Pain persists even after tissues have healed
- Often associated with conditions like fibromyalgia
- Contributing Factors:
- Physical: Injury, overuse, poor posture
- Lifestyle: Stress, sleep quality, overall health
- Psychological: Anxiety, depression, fear of movement
- Social: Work environment, social support
Understanding these pain types and contributing factors can help you manage your pain more effectively.
Pain Neuroscience
Pain is a complex experience that involves more than just physical sensations. Here's what modern pain science tells us:
- Pain is an Output:
- Pain is produced by the brain, not just the tissues
- It's a protective mechanism designed to keep us safe
- Pain ≠ Damage:
- You can have pain without tissue damage and vice versa
- Imaging findings (like rotator cuff tears) don't always correlate with pain
- Pain is Influenced by Many Factors:
- Thoughts, emotions, past experiences, and beliefs can all affect pain
- Stress, lack of sleep, and poor overall health can increase pain sensitivity
- Pain Can Change:
- The nervous system can become more sensitive over time (central sensitization)
- This can lead to pain that persists even after tissues have healed
- Pain Education Helps:
- Understanding pain can reduce fear and improve outcomes
- Knowledge empowers you to take control of your pain
- Active Approaches Work Best:
- Movement and exercise are key components of pain management
- Passive treatments alone are often less effective in the long term
By understanding these principles, you can approach your shoulder pain with a more comprehensive perspective, leading to more effective management strategies.
[Learn More About Pain Neuroscience]
Treatment Options
Treatment Options
- Conservative Management:
- Rest and activity modification
- Ice or heat therapy
- Gentle exercises
- Physical Therapy:
- Targeted exercise programs
- Manual therapy
- Posture and movement education
- Medications:
- Over-the-counter pain relievers
- Prescription anti-inflammatories (when appropriate)
- Advanced Interventions:
- Corticosteroid injections
- Platelet-Rich Plasma (PRP) therapy
- Surgery (in severe cases)
Most shoulder conditions respond well to conservative treatment without needing surgery.
Whole Body Health
Your shoulder health is connected to your overall well-being:
- Regular Physical Activity: Aim for 150 minutes of moderate exercise weekly
- Proper Nutrition: Eat a balanced diet rich in anti-inflammatory foods
- Stress Management: Try relaxation techniques like deep breathing or meditation
- Adequate Sleep: Aim for 7-9 hours per night for tissue repair and pain management
- Ergonomics: Set up your environment to support good posture
FAQs
Q: How long does shoulder pain recovery take?
A: It varies, but many see improvement in 4-6 weeks with proper management. Full recovery can take greater than 3 months in most cases.
Q: Is shoulder cracking or popping normal?
A: Occasional painless popping is usually normal. If it's painful, causes weakness, or happens often, consult a professional.
Q: Can I exercise with shoulder pain?
A: Gentle exercise often helps, but avoid activities that significantly increase pain. Consult a physiotherapist for a tailored program and for clarity when you are safe to exercise into tolerable amounts of discomfort/pain.
