Shoulder Pain

Want to learn more about shoulder pain?

Lachie Cooper, Physiotherapist, has answered some common questions.

Check them out below!

If I’ve dislocated my shoulder, will I be able to avoid surgery?

Not necessarily, although, this decision should be made in collaboration with an orthopaedic surgeon!

Although here are my two cents:

Not all dislocations are the same, and there are several variables which will determine whether a patient is more suited to conservative management or if they will require surgery. Various tissues may be injured when a dislocation occurs, including bone, capsule, ligament, labrum and tendon. The tissues involved and extent of damage, alongside the patient’s age and physical activity requirement are considered when making this decision. Ultimately, the goal of treatment will be to avoid recurrent dislocations and reduce symptoms associated with tissue injury. There are many patients we see who do not opt to undertake surgery, although require a reasonable bout of rehabilitation to ensure that function of the shoulder has been adequately restored.

 

How do I manage a rotator cuff tear?

There is fairly significant variability in management for rotator cuff tears depending on a variety of factors. In older patients, with partial thickness tears will often manage well with rehabilitation, including strengthening of the glenohumeral and scapulothoracic musculature, range of motion and control exercises. Of course, these exercises need to be tailored to suit the individual. If the tear size is larger, or the patient is failing conservative management, it may be worthwhile seeing an orthopaedic surgeon. At the opposite end of the spectrum, younger patients with cuff tears are typically referred for a surgical opinion sooner rather than later.

 

Should I be worried about clicking in my shoulders?

If the clicking is not accompanied by pain, discomfort, swelling, loss of strength or function, then typically no! It is quite normal for healthy joints to click and make sounds. Evidently, symptomatic clicking can be associated with tissue injury or a condition, so may be worthwhile getting it checked out.

 

How do I exercise my rotator cuff?

I commonly see people in gyms completing internal or external rotation exercises in the gym with the belief these must be completed to strengthen and train their rotator cuff. The rotator cuff should be working with pushing, pulling and pretty much all lifting exercises, so it will still be getting a workout!

 

I keep getting pain with overhead lifting in my shoulder, what can I do?

Pain in the shoulder with overhead lifting may be due to a variety of reasons and which should be systematically checked. Some contributing factors I look at addressing with overhead lifting include thoracic extension range of motion, scapula (shoulder blade) retraction and posterior tilt control and strength, glenohumeral (shoulder joint) range of motion and strength. A deficit along any of these links of the kinetic chain may influence ability to lift overhead. Evidently, there will be some cases where if we simply manage the presenting condition, the ability to lift overhead will improve without needing to specifically target any of the aforementioned deficits with exercises.

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