Shoulder Pain, Shoulder Problems & Shoulder Dysfunction by Tony Gill

Read on to find out about common shoulder complaints, their common symptoms and treatments. All you need to find out about your shoulder pain, common shoulder problems or shoulder dysfunction and what we can do at Bristol Physio to help. 

The most common of shoulder problems, this is a symptom not a diagnosis, as lots of separate conditions cause impingement.

Overuse, trauma, rotator cuff weakness or rotator cuff tear all cause Impingement.

Symptoms:

* Pain raising the arm above horizontal or above the head

* A weak shoulder with power movements like throwing can be painful to lie on

* Usually has a good hand behind the back movement

Treatment:

*  Manual therapy can help reduce pain in tight and weak  painful muscles and joints

* Specific exercises are really the key to retrain the Rotator Cuff to optimise the shoulder control. This includes exercise and posture work to maximise the trunk and Scapula control which are the base the shoulder works from

* I use exercises such as Lucky Cat, Scapula press and sleeper stretch from Bristol Physio’s  youtube channel. These exercises and others at the right time, intensity and frequency can help retrain the shoulder control and resole pain.

* Shockwave therapy can be used to reduce or resolve pain and allow rehabilitation to optimise the shoulder.

* Ultrasound Guided Steroid injections can be used effectively to reduce pain and allow a pain free window of opportunity to maximise rehabilitation for the shoulder. These are available from Tony Gill in-house at the Clifton Branch when deemed clinically appropriate.

* Contact Bristol Physio to book in with any of our therapists to diagnose and begin effective treatment for this condition.

If you are suffering from a shoulder problem then book an appointment with Tony Gill or any of our fab therapists to guide you through your rehabilitation. Click here to book. All of our therapists are all our fully qualified and extremely experienced, who have spent years training with Tony. They are more than happy to help. 

Also known as Adhesive Capsulitis, this is a condition that usually occurs in our late 40’s to 60’s and has genetic links. Early diagnosis is crucial as treatment is far more effective in the first 6 weeks and we strongly recommend an early Steroid injection  or Hydrodilatation as this condition can last anywhere between 6 months and 3 years.

In the initial stages inappropriate therapy can actually prolong the condition and lead to more pain and dysfunction and why it is important to be seen by a specialist who can recognise this condition and arrange the most effective treatment.

Here at Bristol Physio we are able to assess and diagnose this condition to ensure you are offered the best treatment options as quickly as possible. 

This condition usually has 3 stages:

* The initial painful stiffening freezing phase

* The less painful but stuck frozen phase

* Finally the improving thawing phase.

It can give mild-moderate or severe pain; but being given the diagnosis, understanding the condition, and realising it will improve is sometimes all people need on the path to recovery.

Symptoms:

* Shoulder begins to stiffen

* Reduced movements behind the back and out to the side

*  Painful to lie on and severe pain with reaching out movements or jerk movements.

* Pain and lack of mobility are more of a problem than weakness

Treatment:

* Early treatment usually involves discussion regarding a capsular Steroid injection which we are able to perform in clinic.

* If symptoms are not too severe, we treat the associated cervical and myofascial symptoms allowing time to resolve the problem.

* Care needs to be taken not to flare the shoulder and worsen or prolong the problem and why we advise professional help.

* Contact Bristol Physio to book in with any of our therapists to diagnose and begin effective treatment for this condition.

If you are suffering from a shoulder problem then book an appointment with Tony Gill or any of our fab therapists to guide you through your rehabilitation. Click here to book. All of our therapists are all our fully qualified and extremely experienced, who have spent years training with Tony. They are more than happy to help. 

Under the age of 30 these are rare and usually involve a high impact trauma. 

As we age and get closer to 50-60 years even small forces can cause a tear in an already worn tendon. 

At 85 over 90% of us will have a degenerative partial to full thickness tear without necessarily having pain.

Symptoms: 

* Similar symptoms as shoulder impingement

* When the symptoms are more severe we are unable to move the arm away from the body with any power

* You might be able to move the injured arm fully using the other arm. This indicates the stability muscles may be torn.

Treatment:

* Treatment depends on accurate diagnosis highlighting why suspected tears should be seen by a specialist.

* If a large tear is suspected, this should be referred for investigation and a shoulder surgeon's opinion. We have excellent links to surgeons in the area and can have you seen rapidly when required.

* Bristol Physio is also able to offer Ultrasound investigation to assess the extent of the tear and whether this is small, large or irreparable. This will alter management.

* Smaller tears can potentially be optimised with therapy and even larger tears that are non operable can be treated effectively with specialist physiotherapy. 

* We also offer Steroid Injection to reduce pain in non-operable and small tears and is again available from Bristol Physio when deemed appropriate.

* Contact Bristol Physio to book in with any of our therapists to diagnose and begin effective treatment for this condition.

If you are suffering from a shoulder problem then book an appointment with Tony Gill or any of our fab therapists to guide you through your rehabilitation. Click here to book. All of our therapists are all our fully qualified and extremely experienced, who have spent years training with Tony. They are more than happy to help. 

Shoulder Instability is a big group of problems including Dislocation, Labral tear, Hyper-mobility, laxity, Muscle patterning, Subluxations. 

Symptoms:

* There are 3 main types of instability:

- A)  Trauma or structural instability

- B)   Non structural, usually linked to hypermobility 

- C)  Muscle patterning where the large muscles pull the shoulder out of place and can be due to structural or non structural

* This is too big a group to discuss in a simple page but if you have:

- dislocated your shoulder and continue to have problems...

- feel the shoulder keeps popping out or almost popping out...

- or the shoulder is weak after a trauma...

then it should have a specialist assessment from a shoulder therapist or surgeon.

* Not all instability is due to a trauma and we do see instability with shoulder subluxation or dislocation with body hypermobility and muscle patterning

* If your shoulder feels unstable with or without trauma then a specialist assessment is warranted

Treatment:

* This depends on the diagnosis but with stable labral tears, laxity without trauma or hyper-mobility, very specialist exercise and therapy is required.

* This can get very complex and usually the area we shoulder specialist therapists spend a great deal of time rehabilitating.

* For the dislocation group it is very important we make sure there is no structural damage and we usually organise specific scans and/or shoulder surgeon advice to ensure you have the best treatment.

* Specific treatment usually focuses on retraining the way the shoulder stabilises and controls forces under stress and load.

* We tailor the rehabilitation to the type of instability and what you expect your shoulder to be able to do and thus a pitcher requires different rehabilitation to tennis player, or a football goalie or a bowls player.

*  Tony Gill is a member of BESS and has been a specialist for over a decade in this field. He is more than happy to assess and rehabilitate these complex shoulders.

* Contact Bristol Physio to book in with any of our therapists to diagnose and begin effective treatment for this condition.

If you are suffering from a shoulder problem then book an appointment with Tony Gill or any of our fab therapists to guide you through your rehabilitation. Click here to book. All of our therapists are all our fully qualified and extremely experienced, who have spent years training with Tony. They are more than happy to help. 

This is becoming far more prevalent with the use of laptops, mobile phones, Ipads and general reduced extension or upright activities in our lives.

Symptoms:

* Pain in the upper trapezius and scapula and upper back region

* Can be worse with static sitting postures and also give us pain in the neck area

Treatment:

* Treating this effectively requires your full effort to work on posture changes, exercise to stabilise and give more power to your upper trunk.

* Awareness of the bad habits that are adding to the problem

* A good therapist will spend time identifying these as well as giving specific exercise and lifestyle changes.

* We also use manual techniques to change the joint stiffness, muscle tightness and pain.

* YouTube exercises like founder and thoracic foam rolling can help some individuals and are often prescribed for this type of problem.

* We always advise you see a physio before starting these programs to make sure they are right for you.

* Contact Bristol Physio to book in with any of our therapists to diagnose and begin effective treatment for this condition.

If you are suffering from a shoulder problem then book an appointment with Tony Gill or any of our fab therapists to guide you through your rehabilitation. Click here to book. All of our therapists are all our fully qualified and extremely experienced, who have spent years training with Tony. They are more than happy to help.

I see many of these and when we are young it is usually from trauma, even from a fall on an outstretched hand, as well as impact to the shoulder.

These are often missed as a source of continual shoulder pain post road traffic accident (RTA) from the seatbelt.

As we age, usually 40 years onwards, this joint can become slightly degenerative and give pain.

Symptoms:

* Pain on top of the shoulder you can usually put one finger on

* Painful with across body movements and end of range high arc movements

Treatment:

* As a shoulder specialist who is able to treat with steroid injection as well as Physiotherapy; my treatment of choice tends to be a steroid in the vast majority of these as it seems to be the most effective treatment I can offer.

* I also settle them with manual therapy and acupuncture. If the pain is not settling I do not think it is fair to continue to treat you if it is not improving the problem.

* Contact Bristol Physio to book in with any of our therapists to diagnose and begin effective treatment for this condition.

If you are suffering from a shoulder problem then book an appointment with Tony Gill or any of our fab therapists to guide you through your rehabilitation. Click here to book. All of our therapists are all our fully qualified and extremely experienced, who have spent years training with Tony. They are more than happy to help.

If you are suffering from an shoulder problem then book an appointment with Tony Gill or any of our fab therapists to guide you through your rehabilitation.

 Click here to book.