How physiotherapy treats shoulder pain and injuries

Shoulder pain can be debilitating, regardless of whether you’re an elite sports person, a manual worker, or just an everyday person suffering from shoulder discomfort.

There are a range of common shoulder conditions that we regularly treat, most notably shoulder dislocations and instability, and frozen shoulder. Physiotherapy is a valuable form of treatment for these and other shoulder complaints as it can help in the management of pain and rehabilitation, regardless of whether it’s a new injury or pain and discomfort you have been experiencing for some time. 

While shoulder physiotherapy can encompasses a combination of manual therapies and exercises, alongside pain management techniques and education, the aim is nearly always the same — to restore your confidence, movement and flexibility, and get you back to doing the things you love. 

Shoulder instability and how to treat it

A common shoulder problem our patients commonly face is what is known as a labral tear. This occurs when the labrum (a cartilage that gives stability to the shoulder socket and joint) is torn, either as a result of physical trauma such as a fall, or through repetitive activities involving outstretched arms. 

Initial assessment of a suspected labral tear can be carried out by a physiotherapist, although a MRI scan may be required in order to confirm the diagnosis, as well as the severity of any tear. The severity of the injury will also determine the nature of the treatment required.

Physiotherapy designed to build up strength, stability and control of the shoulder can be used in the treatment of less severe tears. However, in the case of more serious labral tears surgery may be required first, then followed by a program of rehabilitative physiotherapy.

How physiotherapy treats shoulder dislocation 

A shoulder dislocation occurs when the head of the upper arm is no longer in its proper place in the shoulder socket joint. 

This can very often be the result of a sporting injury or trauma, although some people are simply more susceptible to shoulder dislocation than others, meaning that very little force is required for the shoulder to become dislocated.

Shoulder dislocations can manifest in different ways depending on individual physiology. In some instances. the shoulder may go back into place of its accord, known as spontaneous relocation. 

However, in most cases professional assistance will be required to put the shoulder back into its socket. An X-ray may be necessary before this can happen, which can also reveal if there has been a fracture.

After a shoulder dislocation, effective rehab is essential. Key to this will be protecting the shoulder so that it has time to heal. This will help to prevent further damage while promoting healing.

Following this, your physio will work with you to develop and implement a programme of exercises and therapies designed to strengthen muscles and stabilise the shoulder in order to restore its full range of functions. 

What is frozen shoulder and how can physiotherapy help?

When the joint capsule of the shoulder becomes inflamed, it can become stiff and sore, resulting in inhibited movement. Frozen shoulder (also known as adhesive capsulitis) can be the result of an injury or surgery. Frustratingly, it can also affect people for no apparent reason

In most cases, frozen shoulder occurs in three stages, which can be defined as freezing, frozen and thawing. 

Pain first starts to be experienced in the freezing stage, when certain movements produce a twinge or ache. This then leads to more pain, accompanied by restricted movement of the shoulder. Over time, a frozen shoulder can have a significant impact on everyday living activities, and it can affect sleep as well. 

During the frozen stage, while there may be less pain, it will usually be the case that the shoulder joint becomes increasingly stiff and difficult to move.

Physiotherapy during the freezing and frozen stages will largely be about pain management, and helping patients cope with the symptoms and adapt to their particular circumstances.

Finally, in the thawing stage, movement will begin to return and the pain diminish. This final stage (which can take up to two years to reach) can happen naturally, but without treatment a complete return to pain-free mobility may not be possible. This is why physio at this stage is about restoring shoulder strength, increasing mobility and regaining control. 

Talk to a physiotherapist about shoulder pain and injury 

No matter the type of shoulder pain or injury or discomfort you are suffering, one of our physiotherapists can provide advice and guidance on a range of treatments to restore mobility and give you a greater range of shoulder flexibility and movement and pain free function.